Sonohysterography is a useful diagnostic approach for uterine arteriovenous malformation

Mishina, M.; Hasegawa, Junichi; Nakamura, Masamitsu; Ichizuka, Kiyotake; Sekizawa, Akihiko; Okai, Takashi

doi:10.1111/jog.12390

Cited by 8 publications

(6 citation statements)

References 11 publications

(19 reference statements)

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“…Imaging Features.-Imaging for suspected UAVM is usually performed initially with US, particularly with power/color Doppler US, to establish the vascular nature of the abnormality, although sonohysterography can also be performed (63). The latter can be especially helpful to exclude remnant chorionic tissues or aid in diagnosis in equivocal cases (65). US often shows at least a mildly thickened endometrium with a somewhat heterogeneous and often hypoechoic or even tubuliform mass (arteriovenous malformation) that demonstrates turbulent blood flow on color Doppler images (Fig 17).…”

Section: Uterine Arteriovenous Malformationsmentioning

confidence: 99%

Imaging of Pregnancy-related Vascular Complications

et al. 2017

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Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy. The authors review relevant normal physiologic changes of pregnancy, pathophysiologic changes, and imaging features of vascular conditions that can manifest in conjunction with pregnancy. Particular attention is given to pertinent imaging information that radiologists should provide to referring clinicians to optimally affect the management of pregnant patients as well as women in the peripartum and postpartum stages. Among the complications discussed are preeclampsia; hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome; spontaneous coronary artery dissection; placental abruption; amniotic fluid embolism and acute pulmonary embolism; dural venous sinus thrombosis; ovarian vein thrombophlebitis; vasa previa; uterine arteriovenous malformations; heritable aortopathies; and hereditary hemorrhagic telangiectasia. To help radiologists avoid the use of unnecessary ionizing radiation in pregnancy, imaging examination selection and optimization are also reviewed. Radiologists should be familiar with the physiologic changes of pregnancy, radiation risks during gestation, and pregnancy-related vascular complications to improve imaging examination selection, diagnosis, and clinical management. RSNA, 2017.

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Section: Uterine Arteriovenous Malformationsmentioning

confidence: 99%

Imaging of Pregnancy-related Vascular Complications

et al. 2017

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“…Saline solution infusion sonohysterography may be useful as an aid to detect an AVM. 23 Tal et al 24 The aim of this study was to review the value of TVUS in the diagnosis and treatment of suspected uterine EMV/ AVMs to outline the disease's natural history. In addition to including the wellestablished uterine procedures that predispose to acquired EMV/AVM, this case series directs attention to an emerging link between CSPs and EMV/AVM.…”

mentioning

confidence: 99%

Ultrasound diagnosis and management of acquired uterine enhanced myometrial vascularity/arteriovenous malformations

Timor‐Tritsch

Haynes

Monteagudo

et al. 2016

American Journal of Obstetrics and Gynecology

121

138

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Acquired enhanced myometrial vascularity/arteriovenous malformations occurred after unsuccessful pregnancies or treatment procedures that included uterine curettage, cesarean delivery, or cesarean scar pregnancy. Triage of patients for expectant treatment vs intervention with uterine artery embolization based on their clinical status, which was supplemented by objective measurements of blood velocity measurement in the arteriovenous malformation, appears to be a good predictor of outcome. Ultrasound evaluation of patients with early pregnancy failure and persistent bleeding should be considered for evaluation of a possible enhanced myometrial vascularity/arteriovenous malformation.

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“…Though rare, they have the potential to cause irregular or torrential bleeding which may be at a time life threatening . The incidence of acquired AVM might have been gradually increasing in recent years because of increase in interventions (those following pregnancy, caesarean section, curettage and abortion) . Sometime they are asymptomatic and may undergo spontaneous resolution.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 The incidence of acquired AVM might have been gradually increasing in recent years because of increase in interventions (those following pregnancy, caesarean section, curettage and abortion). 1,2 Sometime they are asymptomatic and may undergo spontaneous resolution. Various imaging modalities have been employed to diagnose AVMs that include, ultrasonography, contrast enhanced CT (CECT), MRI, saline sono-hysterography and angiography.…”

Section: Introductionmentioning

confidence: 99%

Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients

Taneja

Chopra

Kaur

et al. 2019

J of Obstet and Gynaecol

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Aim To study the feasibility of conservative management with progesterone as a treatment option for postabortal patients with uterine arterio‐venous malformations (AVMs). Methods This prospective observational study was conducted in the tertiary care teaching hospital over a period of 2 years. Postabortal patients with abnormal uterine bleeding were enrolled. Diagnosis was made by history, clinical and radiological examinations. Oral norethisterone was used (10 mg twice daily for 3 weeks, maximum of three cycles). Descriptive statistics was used to present the data. Results A total of 30 patients were included. Majority (n = 17) had complete resolution of symptoms after a single 3‐week course of progesterone therapy. Rest (n = 13) remained symptomatic and required second course. Of the later, only three remained symptomatic after 2 months, and underwent CT angiography followed by embolization. There was no report of any serious adverse events. Conclusion Oral norethisterone is a safe, effective and novel oral drug as an alternative to embolization or surgical therapy for patients with postabortal AVM bleed. Larger studies are required to confirm the findings of the present study.

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Sonohysterography is a useful diagnostic approach for uterine arteriovenous malformation

Cited by 8 publications

References 11 publications

Imaging of Pregnancy-related Vascular Complications

Imaging of Pregnancy-related Vascular Complications

Ultrasound diagnosis and management of acquired uterine enhanced myometrial vascularity/arteriovenous malformations

Successful management of abnormal uterine bleeding from uterine arteriovenous malformations with progesterone in postabortal patients

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