Reviewer’s report
Title: 
The implementation of routine procedural transvaginal sonography to
decrease retained products of conception: A quality improvement initiative
Version: 
0 
Date: 
06 Jun 2021
Reviewer's report:
Dear Authors,
Thank you for this interesting paper. The use of transvaginal sonography is
routine in European countries. 
1.) Please explain whether in the cases of retained products you have measured
the level of betahCG, if yes emphasizes the ranges in results. 
2.) The retained products are often characterized by specific doppler findings,
have you performed color doppler?
3.) In what time range have you diagnosed POC?
4.) Explain what was indication for using hysteroscopy (betahCG, doppler
findings??).
5.) how endometritis was diagnosed (clinically or by positive microbiology
findings-uterine cavity)?
6.) Note the dosage of used mifepriston/misoprostol
7.) In cases of PCO it will be of great significance to highlight the reproductive
history of patients who underwent the procedure. You have noted previous CS
and dilatation and curettage procedures, but you have not noted information
about LPSC/HYS myomectomy or at least previous IVF procedure. Each uterine
manipulation can be a risk factor for future PCO.
8.) Further you have patients with Asherman. Have they been scheduled for
future hysteroscopy?
Thank you for answering and explaining above mentioned topics.
I strongly encourage the use of transvaginal sonography as a every day routine
practice. 
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