Acquired uterine arteriovenous malformation developing in retained products of conception: A diagnostic dilemma

• Published in: The journal of obstetrics and gynaecology research Vol. 40; no. 1; pp. 271 - 274
• Main Authors: Goyal, Surbhi, Goyal, Ankur, Mahajan, Surbhi, Sharma, Shikha, Dev, Geeta
• Format: Journal Article
• Language: English
• Published: Australia 01.01.2014
• Subjects: Abortion, Incomplete - surgery; Adult; Arteriovenous Malformations - diagnosis; Arteriovenous Malformations - pathology; Arteriovenous Malformations - physiopathology; Contrast Media; Dilatation and Curettage - adverse effects; Female; gestational trophoblastic disease; Humans; Magnetic Resonance Angiography; Neovascularization, Pathologic - diagnosis; Neovascularization, Pathologic - pathology; Neovascularization, Pathologic - physiopathology; postabortal uterine bleeding; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - pathology; Postoperative Complications - physiopathology; Pregnancy; retained products of conception; uterine arteriovenous malformation; Uterine Artery - pathology; Uterine Diseases - diagnosis; Uterine Diseases - pathology; Uterine Diseases - physiopathology; Uterine Hemorrhage - etiology; Uterus - blood supply; Uterus - pathology; Veins - pathology; postabortal uterine bleeding; retained products of conception; magnetic resonance angiography; gestational trophoblastic disease; uterine arteriovenous malformation
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.12139

Abnormal uterine bleeding in the postabortal period requires meticulous diagnostic work‐up to decide proper management. Imaging modalities including Doppler sonography and magnetic resonance imaging in concert with clinical and laboratory findings are useful to narrow the differential diagnoses but are not definitive. Presence of increased uterine vascularity and arteriovenous shunting is non‐specific and can be detected in a variety of conditions including retained trophoblastic tissue, gestational trophoblastic disease, arteriovenous malformation (AVM), placental polyp and vascular neoplasm. We present here a case of a multiparous woman with unexplained postabortal bleeding posing a diagnostic challenge. Excluding the possibility of AVM before attempting dilatation and curettage in such a clinical scenario is crucial to prevent catastrophic bleeding.