Postpartum or post-abortion bleeding, suspected retained products of conception
Recommended: Transvaginal Pelvic Ultrasound with color Doppler is the preferred imaging study for postpartum or post-abortion bleeding, suspected retained products of conception. Echogenic endometrial mass + increased vascularity.
Recommended study
Transvaginal Pelvic Ultrasound with color Doppler
Echogenic endometrial mass + increased vascularity. Distinguish from blood clot (avascular).
If the default doesn't apply
Equivocal US, persistent symptoms
MRI
MRI Pelvis
IV contrast
Watch-outs
Enhanced myometrial vascularity (AVM-like)
Hypervascular RPOC can mimic uterine AVM — high-flow vessels; consider IR consultation if bleeding severe.
Pearls
- Endometrial thickness > 10 mm + vascular flow = high suspicion.
- Avascular echogenic material likely clot, not RPOC.
- D&C or expectant management depending on patient stability and clinical picture.