Sonographic findings in acute puerperal endometritis

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dc.contributor.author Rule, C en
dc.contributor.author Ashley, L en
dc.contributor.author Bergin, Colleen en
dc.date.accessioned 2019-06-19T01:58:35Z en
dc.date.issued 2018-11 en
dc.identifier.issn 1836-6864 en
dc.identifier.uri http://hdl.handle.net/2292/47192 en
dc.description.abstract Abstract Purpose To evaluate the reliability of the sonographic subserosal hypoechoic rim sign and endomyometrial junction indistinctness in distinguishing patients with acute puerperal endometritis from other common postpartum complications, particularly those with retained products of conception. Methods Radiographic coding identified all patients presenting to Auckland City Hospital over a 12‐month period between 1 March 2016 and 28 February 2017 who had pelvic ultrasound scans to assess for postpartum complications. Clinical notes were reviewed to identify those patients with a clinical diagnosis of acute endometritis. After exclusion criteria were applied, the ultrasound images of 31 patients with acute endometritis and 31 randomly selected controls from the remaining pool of postpartum patients were randomised and anonymised. Ultrasound images were retrospectively reviewed by two independent radiologists to identify the presence or absence of the hypoechoic subserosal rim and endomyometrial junction indistinctness signs. Results The average sensitivity and specificity for readers identifying the subserosal hypoechoic rim sign in full‐term postpartum patients with acute endometritis were 76.9% and 92.1%, respectively. Interobserver reliability was moderate with a kappa value of 0.5. The average sensitivity and specificity for endomyometrial junction indistinctness were 89.0% and 95.2%, respectively, with substantial inter‐observer agreement, Kappa 0.7. These signs remained specific but were less frequently observed in postpartum patients scanned during early pregnancy. Conclusion We have shown that identifying the subserosal hypoechoic rim and endomyometrial junction indistinctness on ultrasound scans can reliably help to distinguish patients with acute postpartum endometritis from other complications, particularly in full‐term postpartum patients. en
dc.publisher Wiley-Blackwell en
dc.relation.ispartofseries Australasian Journal of Ultrasound in Medicine en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Sonographic findings in acute puerperal endometritis en
dc.type Journal Article en
dc.identifier.doi 10.1002/ajum.12112 en
pubs.issue 4 en
pubs.begin-page 234 en
pubs.volume 21 en
dc.rights.holder Copyright: The author en
pubs.end-page 240 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 765446 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Anatomy and Medical Imaging en
pubs.record-created-at-source-date 2019-03-04 en


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