Diagnostic dilemma in post-abortion intrauterine retention: endometrial polyps mimicking retained products of conception.

Objective: This retrospective study investigated the characteristics of endometrial polyps identified during incomplete abortion management and evaluated differences between these polyps and retained products of conception. Methods: Patients with intrauterine retention within 4 months after abortion were enrolled in this study between January 2019 and December 2024. Twenty-six patients with pathologically confirmed endometrial polyps were included in the case group, while fifty-two patients with confirmed retained products of conception (RPOC) comprised the control group. The groups were matched in a 1:2 ratio based on gestational age (±1 week). Results: Twenty-six study group patients were included; 69.2% (18/26) were nulliparous. Abortions occurred in gestational age of 6-14 weeks. No polyps were identified prior to subsequent surgical intervention. Hysteroscopy was performed on 24 women. In hysteroscopic cases, no endometrial polyp was larger than 2 centimeters in size. Compared with control group, the study group had lower gravidity (1 [0-3] vs. 2 [0-8], Conclusions: Endometrial polyps should be considered in stable women after abortion with intrauterine retention present with low blood flow on doppler, low β-hCG levels, and prolonged retention, especially in women with lower gravidity. Hysteroscopy is recommended for accurate diagnosis and proper management, preventing unnecessary treatment for presumed retained products of conception.