Transvaginal Color Doppler Imaging of Uterine Contractions in Early Pregnancies: Significance of Uterine Contractions in Early Pregnancy Failure

Abstract

PURPOSE: To assess uterine contractions in early pregnancies using transvaginal color Doppler sonography(TVCDS) and to determine the role of uterine contractions in the diagnosis of early pregnancy fail-ure. MATERIALS and METHODS: 76 patients with abnormal pregnancy diagnosed by sonography or histopathology up to 10 weeks of gestation and 38 normal pregnant women as the control group were examined with TVCDS. The pres-ence of uterine contractions was determined by complete or partial disappearance of the color flow signals of vessels within myometrium, and the direction, amplitude(grade 1-3), and interval of uterine contractions were also evaluated. RESULTS: Uterine contractions were identified in 42(55.3%) of 76 patients with abnormal pregnancy, whereas they were detected only in 2(5.3%) of 38 normal pregnant women who had initial grade 1 contraction but disap-peared in the follow-up study. In 26 patients with blighted ovum or missed abortion, 15 patients(57.7%) showed uterine contraction of grade 1 in 3 cases, grade 2 in 8 cases, and grade 3 in 4 cases and interval from 45 seconds to 5 minutes. In 30 patients with inevitable or incomplete abortion, 23 patients(76.7%) showed uterine contrac-tion of grade 1 in 2 cases, grade 2 in 9 cases, and grade 3 in 12 cases and interval from 1 to 5 minutes. 4(20%)of 20 patients with threatened abortion had uterine contraction of grade 2 and interval from 2 to 4 minutes. The p-resence of uterine contractions was significantly different in abnormal pregnancies compared with that of nor-mal and also among the three different groups of abnormal pregnancies, but the amplitude did not diff e r. CONCLUSION: It is suggested that uterine contractions in early pregnancy are related to the cause of early pregnancy failure or the evacuation of products of conception, and the presence of uterine contractions on TVCDS may be