Abstract
Uterine myometrial arteriovenous malformations (AVM) are reported on color doppler ultrasonography as mosaic pattern of blood flow with different peak systolic velocities (PSV) at different places. High PSV within the AVM may require arterial embolization as treatment. However, we present a case of traumatic AVM with incomplete abortion managed by hysteroscopic cold knife evacuation. This case report is of a young patient with off and on vaginal bleeding for 3 1/2 months following 2nd trimester spontaneous abortion. She had undergone dilation and evacuation (D & E) for incomplete abortion. Now the bleeding was heavy and intermittent not responding to medications. The subsequent TVS examination shows incomplete abortion with myometrial AVM with high PSV. Hysteroscopic cold knife removal of products of conception resulted in immediate resolution of Uterine AVM.
Highlights
Uterine myometrial arteriovenous malformations (AVM) are reported on color doppler ultrasonography
We present a case of traumatic AVM with incomplete abortion managed by hysteroscopic cold knife evacuation
Uterine myometrial AVM are reported on color doppler ultrasonography
Summary
Uterine myometrial AVM are reported on color doppler ultrasonography. They are mentioned as enhanced myometrial vascularity, especially in post-partum period. These are rare tangled mass like conglomerate between artery and vein without interposition of capillary connection. AVM are reported in the retained products within the uterine cavity [5]. Published case reports and case series described uterine artery embolization (UAE) as method of treatment used in patients with uterine AVM with high PSV on color doppler USG. D & E may or may not be for retained products after this procedure In this case report of uterine AVM with high PSV, successful treatment was achieved without UAE
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