{"title":"妊娠后血管保留产物：雌激素-孕激素治疗的疗效。","authors":"Munekage Yamaguchi, Takeshi Motohara, Takashi Ohba, Eiji Kondoh","doi":"10.1002/jcu.24031","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical features of women with vascular retained products of conception (RPOC) following delivery and to assess the efficacy of estrogen-progestogen therapy (EPT) as an initial intervention for this group.</p><p><strong>Methods: </strong>A retrospective study was conducted of women with vascular RPOC after delivery at ≥ 20 weeks gestation who received EPT (combination of conjugated estrogen and norethisterone) between 2017 and 2023. Clinical characteristics, hormonal levels, ultrasonographic assessments, and treatment outcomes were analyzed.</p><p><strong>Results: </strong>A cohort of 21 women with vascular RPOC following delivery was identified. The median interval from delivery to initial hospital consultation was 48 days (IQR: 33-50), with five patients requiring inpatient care due to substantial bleeding. Among the 21 patients, 18 received EPT. Following the first course of EPT and subsequent withdrawal bleeding, 17 (94%) showed resolution of vascularity on color Doppler, and 11 (61%) exhibited a linear endometrial pattern. All patients completed treatment within two EPT courses, with no need for further intervention. The median time to human chorionic gonadotropin normalization from EPT initiation was 14 days (IQR: 3-25).</p><p><strong>Conclusion: </strong>EPT incorporating norethisterone appears effective in attenuating and eliminating endometrial blood flow in women with vascular RPOC after delivery, facilitating intrauterine tissue expulsion without additional treatments.</p>","PeriodicalId":15386,"journal":{"name":"Journal of Clinical Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Vascular Retained Products of Conception Following Delivery: Efficacy of Estrogen-Progestogen Therapy.\",\"authors\":\"Munekage Yamaguchi, Takeshi Motohara, Takashi Ohba, Eiji Kondoh\",\"doi\":\"10.1002/jcu.24031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the clinical features of women with vascular retained products of conception (RPOC) following delivery and to assess the efficacy of estrogen-progestogen therapy (EPT) as an initial intervention for this group.</p><p><strong>Methods: </strong>A retrospective study was conducted of women with vascular RPOC after delivery at ≥ 20 weeks gestation who received EPT (combination of conjugated estrogen and norethisterone) between 2017 and 2023. Clinical characteristics, hormonal levels, ultrasonographic assessments, and treatment outcomes were analyzed.</p><p><strong>Results: </strong>A cohort of 21 women with vascular RPOC following delivery was identified. The median interval from delivery to initial hospital consultation was 48 days (IQR: 33-50), with five patients requiring inpatient care due to substantial bleeding. Among the 21 patients, 18 received EPT. Following the first course of EPT and subsequent withdrawal bleeding, 17 (94%) showed resolution of vascularity on color Doppler, and 11 (61%) exhibited a linear endometrial pattern. All patients completed treatment within two EPT courses, with no need for further intervention. The median time to human chorionic gonadotropin normalization from EPT initiation was 14 days (IQR: 3-25).</p><p><strong>Conclusion: </strong>EPT incorporating norethisterone appears effective in attenuating and eliminating endometrial blood flow in women with vascular RPOC after delivery, facilitating intrauterine tissue expulsion without additional treatments.</p>\",\"PeriodicalId\":15386,\"journal\":{\"name\":\"Journal of Clinical Ultrasound\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-04-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Ultrasound\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jcu.24031\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Ultrasound","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jcu.24031","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ACOUSTICS","Score":null,"Total":0}
Vascular Retained Products of Conception Following Delivery: Efficacy of Estrogen-Progestogen Therapy.
Objective: To evaluate the clinical features of women with vascular retained products of conception (RPOC) following delivery and to assess the efficacy of estrogen-progestogen therapy (EPT) as an initial intervention for this group.
Methods: A retrospective study was conducted of women with vascular RPOC after delivery at ≥ 20 weeks gestation who received EPT (combination of conjugated estrogen and norethisterone) between 2017 and 2023. Clinical characteristics, hormonal levels, ultrasonographic assessments, and treatment outcomes were analyzed.
Results: A cohort of 21 women with vascular RPOC following delivery was identified. The median interval from delivery to initial hospital consultation was 48 days (IQR: 33-50), with five patients requiring inpatient care due to substantial bleeding. Among the 21 patients, 18 received EPT. Following the first course of EPT and subsequent withdrawal bleeding, 17 (94%) showed resolution of vascularity on color Doppler, and 11 (61%) exhibited a linear endometrial pattern. All patients completed treatment within two EPT courses, with no need for further intervention. The median time to human chorionic gonadotropin normalization from EPT initiation was 14 days (IQR: 3-25).
Conclusion: EPT incorporating norethisterone appears effective in attenuating and eliminating endometrial blood flow in women with vascular RPOC after delivery, facilitating intrauterine tissue expulsion without additional treatments.
期刊介绍：
The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography.
The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents.
JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.
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