ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG NHỮNG TRƯỜNG HỢP SÓT RAU SAU ĐÌNH CHỈ THAI QUÝ 1

Abstract

Objective: To describe the clinical and paraclinical characteristics of patients diagnosed with retained products of conception (RPOC) after first-trimester pregnancy termination at the Department of Infectious Obstetrics – National Hospital of Obstetrics and Gynecology, from January 1, 2023, to December 31, 2024. Methods: This was a retrospective cross-sectional study conducted on 234 cases diagnosed with retained products of conception (RPOC) following first-trimester pregnancy termination. The mean age of patients with retained products was 34,53 ± 6,27 years.. The majority of pregnancies were terminated before 7 weeks of gestation (72.6%). Most procedures were performed at private clinics (62%). Among the cases, 118 patients underwent Medical Abortion (MA) and 116 patients underwent Manual Vacuum Aspiration( MVA). All patients were treated at the Department of Infectious Obstetrics, National Hospital of Obstetrics and Gynecology, from January 2023 to December 2024. Results:  97% of patients with RPOC presented with vaginal bleeding, mostly mild in volume (86,8%). The duration of bleeding ranged from 1 to 77 days, with an average of 18,73 ± 16,57 days. The highest proportion (39,3%) experienced bleeding lasting ≥ 21 days. There was no significant difference in bleeding duration between Medical Abortion and Manual Vacuum Aspiration groups. Abdominal pain was reported in 21,4% of cases, and fever occurred in 0,9%. The mean pre-treatment serum beta-hCG level was 2693,36 ± 10249,32 IU/L, ranging from <5 to 117428 IU/L. No cases of severe anemia were recorded; mild anemia was observed in 6% and moderate anemia in 3,8% of patients. Ultrasound findings revealed that 94,4% of patients had intrauterine heterogeneous echogenic masses with the largest mass measured 76×18 mm. Additionally, 5,6% of patients showed an irregular endometrial lining on ultrasound. Conclusion: The primary clinical symptom of retained products of conception (RPOC) after first-trimester pregnancy termination is vaginal bleeding, accounting for 97% of cases. The bleeding is typically prolonged and scanty, with the shortest duration being 1 day and the longest 77 days, averaging 18,73 ± 16,57 days. The main paraclinical finding is the presence of a heterogeneous echogenic mass within the uterine cavity on ultrasound, observed in 94.4% of patients. The mean pre-treatment beta-hCG level was 2693,36 ± 10249,32 IU/L, ranging from <5 IU/L to a maximum of 117,428 IU/L.