Intrauterine blood clot can result from a number of situations in gravid, non-gravid and postpartum states. It can mimic many other pathologies.
Any condition that predisposes to an intrauterine haemorrhage can potentially result in an intrauterine blood clot.
- 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
- colour Doppler interrogation shows no associated flow: this can be a useful distinction with other differential diagnoses
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 colour 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
- 1. Nalaboff KM, Pellerito JS, Ben-levi E. Imaging the endometrium: disease and normal variants. Radiographics. 21 (6): 1409-24. Radiographics (full text) - Pubmed citation
- 2. Williams PL, Laifer-narin SL, Ragavendra N. US of abnormal uterine bleeding. Radiographics. 23 (3): 703-18. doi:10.1148/rg.233025150 - Pubmed citation