5 years ago

Diagnosis and Management of Patients with Enhanced Myometrial Vascularity Associated with Retained Products of Conception

Beryl R. Benacerraf, Amie Lynn Healy Murphy, Yvette S. Groszmann
Objectives We performed this study to assess the complication rate, including the estimated amount of blood loss, in patients who underwent dilation and curettage for treatment of retained products of conception with markedly enhanced myometrial vascularity mimicking arteriovenous malformations. Methods This is a retrospective medical records review study of patients with retained products of conception with enhanced myometrial vascularity presenting to our ultrasound unit between August 1, 2015 and August 1, 2017. Color Doppler imaging was used subjectively to identify the degree and extent of vascularity. All patients underwent dilation and curettage and the operative reports and medical records reviewed to identify if ultrasound guidance was used, the estimated blood loss and complications during or after the procedure. Results The study group included 31 patients. 7/31 had retained products of conception after a vaginal delivery and 24/31 after a first trimester spontaneous or induced abortion. The largest dimension of the region of enhanced myometrial vascularity ranged from 10 mm to 53 mm with 15/31 having a width ≥ 20 mm. 15/31 had a standard dilation and curettage procedure, 13/31 had an ultrasound guided procedure and 3/31 were performed with hysteroscopy. Estimated operative blood loss varied from a report of “minimal” to a maximum of 400 cc. There were no intraoperative complications, 1/31 patients was treated for endometritis. Conclusion An increasing number of studies describe the enhanced myometrial vascularity associated with retained products of conception as “acquired arteriovenous malformations” with some recommending management with uterine artery embolization. Our study demonstrates that the enhanced myometrial vascularity is associated with retained products of conception and surgical removal by D&C, possibly with the aid of ultrasound guidance or hysteroscopy, is safe.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1002/uog.18954

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.