Year: 2021
Type: conference-abstract
Abstract: Acquired Arteriovenous Malformation (AVM), also referred to as Enhanced Myometrial Vascularity (EMV) is an uncommon vascular structural abnormality associated with uterine intervention (such as curettage or Caesarean), and is thought to be underdiagnosed. We present a 37-year-old woman, G3 P1, with one previous Caesarean section. She was admitted at our hospital complaining of vaginal bleeding, referring a recent spontaneous first trimester pregnancy loss, with no surgical treatment needed. On presentation she was hemodynamically stable, and the speculum examination showed minimal active bleeding. Ultrasound assessment demonstrated an irregular hypoechogenic, tubular structure within the myometrium. On power Doppler imaging, a tortuous network of the vascular malformation stands out, with turbulent flow, appearing as a large vascular lake, shown in image 1. She had a serum HCG of 142 mlU/ml. Clinicians suspected of EMV/AVM. The decision was made to take on conservative management and uterotonic medication. Three months after the diagnosis ultrasound findings showed a thin, regular endometrium and homogenous myometrium. Colour Doppler evaluation demonstrated minimal peripheral vascularity of the myometrium. This case study demonstrates the importance of using ultrasound with Doppler in the evaluation of myometrial findings, since it allows a diagnosis often missed. It could assist in differentiating between retained products of conception and EMV/AVM. An early diagnosis and treatment provides a better prognosis and prevents the physician from doing hazardous procedures such as uterine curettage. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
DOI: 10.1002/uog.24041
Authors: G.V. Almeida, P. Pinto, A. Lacerda
Institutions: Hospital de São Bernardo, Unidade Local de Saúde de São José
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3206049364