Intrauterine blood clot can result from a number of situations in gravid, non-gravid and postpartum states. It can mimic many other pathologies.
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Pathology
Any condition that predisposes to an intrauterine hemorrhage can potentially result in an intrauterine blood clot.
Radiographic features
Ultrasound
- may be seen as material expanding the uterine cavity (if large) or focal intracavitary content (if small)
- the echotexture is usually heterogeneous although can vary according to the stage of clot
- color Doppler interrogation shows no associated flow: this can be a useful distinction with other differential diagnoses
Differential diagnosis
There can be a relatively wide differential depending on the clinical context:
- if following a miscarriage, consider retained products of conception (RPOC): often has associated increased Doppler color flow (though note that RPOC may be avascular)
- if following an intra-uterine procedure, consider intrauterine gossypiboma
- if there are the multiple small cystic spaces with a positive beta HCG, consider molar pregnancy
- if there is thickening of the endometrium with small cystic spaces with a negative beta HCG, consider tamoxifen-induced endometrial changes