Endometrial thickness after dilation and evacuation: A retrospective cohort study

Abstract

Abstract Objective To evaluate endometrial thickness 1–2 h after dilation and evacuation (D&E). Methods We used a deidentified single‐institution database to retrospectively evaluate endometrial thickness measurements obtained as part of routine care 1–2 h postprocedure using transabdominal ultrasonography from 17 March 2020 to 16 October 2020. From this database, we extracted measurements, procedural outcomes and postoperative bleeding interventions. We assessed our primary outcome of endometrial thickness and the relationship between endometrial thickness and the need for bleeding‐related interventions within 4 h postprocedure. Results We performed 213 endometrial thickness evaluations at a mean gestational age of 19.2 ± 2.8 weeks with median quantitative intraoperative blood loss of 150 mL (10–2000 mL). We found a median endometrial thickness of 12.2 mm (interquartile range [IQR]: 9.1–16 mm) performed 89.6 ± 19.3 min after the D&E. Eleven (5.2%) patients needed further interventions for bleeding during recovery, with all but one having bleeding issues before or at the same time as the ultrasound examination. Patients with and without bleeding issues had median endometrial thicknesses of 20.3 mm (IQR: 12.5–29.2 mm, range: 1.2–42 mm) and 12.2 mm (IQR: 9.0–15.8 mm, range: 2.1–43 mm), respectively, p = 0.008. Conclusion Endometrial thickness 1–2 h after D&E can vary widely but 75% of patients have a measurement <16 mm. Although patients with bleeding complications have slightly thicker endometrial linings, these patients typically present clinically and endometrial assessment does not predict the need for intervention.

Keywords

• abortion
• dilation and evacuation
• endometrial thickness
• haemorrhage
• ultrasonography