Enhanced myometrial vascularity: case presentation and review

نویسندگان

چکیده

ObjectiveTo describe the etiology of arteriovenous malformations (AVM) and enhanced myometrial vascularity (EMV), review updates in management for patients with retained products conception (RPOC) associated EMV through a case presentation.DesignA 6-minute narrated video discusses recent distinction between AVM. The etiology, symptoms, imaging findings/interpretation, based on symptoms are reviewed detail. As this represents single report, it does not meet definition research according to regulations at 45 CFR 46.102(l); therefore, institutional board approval was required.SettingTertiary referral center.Patient(s)Eight weeks after suction dilation curettage (D&C) an incomplete abortion, 28-year-old gravida 1, para 0 patient presented outside facility RPOC, menorrhagia, acute decrease hemoglobin. After uterine AVM diagnosed, she transferred our further care.Intervention(s)After transfer center, ultrasound demonstrated prominent internal vasculature containing peak systolic velocity >20 cm/s. A diagnosis made. Magnetic resonance confirmed serpentine vessel endometrium RPOC within cavity (Fig. 1). Due her anemia, underwent artery embolization (UAE) followed by D&C 2). Hysteroscopy performed before curettage, large vascular bundle appreciated surface endometrium.Main Outcome Measure(s)None.Result(s)The clinic 2 postoperatively resolution abnormal bleeding negative ?-human chorionic gonadotropin test.Conclusion(s)Management is dependent extent their symptoms. If significant present, surgical required. Previous reports suggested that should undergo UAE D&C, but more studies suggest may be initiated without UAE, as normal transient placentation phenomenon have less risk hemorrhage than previously suspected. However, preoperative and/or we propose still considered. Each requires individualized signs, imaging, plans future fertility. ideal remains determined. To presentation. Tertiary center. Eight care. endometrium. None. test. Management

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ژورنال

عنوان ژورنال: Fertility and Sterility

سال: 2021

ISSN: ['0015-0282', '1556-5653']

DOI: https://doi.org/10.1016/j.fertnstert.2021.05.097