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      Increased endometrial vascularity and intraoperative haemorrhage among women undergoing surgical evacuation for retained product of conception

      research-article
      , MBBS 1 , , FRANZCOG, DDU 1 ,
      Australasian Journal of Ultrasound in Medicine
      John Wiley and Sons Inc.
      endometrial vascularity, Doppler, secondary postpartum haemorrhage

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          Abstract

          The aim of this study was to ascertain the incidence of “increased endometrial vascularity” recorded in the ultrasound scan reports, in the context of RPOC and correlate this finding with the incidence of life threatening intra‐operative bleeding.

          Ultrasound scan reports sometimes mention the presence of increased endometrial / sub‐endometrial vascularity in the context of retained products of conception or secondary post partum haemorrhage. This raises the possibility of serious intra‐operative haemorrhage in the minds of the junior doctors because of the possibility of arterio‐venous malformation. This retrospective case series was designed to find the incidences of increased endometrial vascularity and severe intra‐operative haemorrhage in the patients with RPOC in the south eastern part of Melbourne population. The study found that the incidence of increased endometrial vascularity was 7.57% and none of these patients suffered severe intra‐operative haemorrhage. A literature survey revealed that there were few studies on this topic.

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          Most cited references9

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          The sonographic and color Doppler features of retained products of conception.

          The purpose of this study was to identify the sonographic features of retained products of conception (RPOCs).
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            Retained Products of Conception: Spectrum of Color Doppler Findings

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              Uterine arteriovenous malformation--a rare cause of uterine haemorrhage.

              Uterine arteriovenous malformation (AVM) is a rare cause of massive uterine bleeding, with 70 cases reported in the English literature. Although uterine AVM is a rare cause of menorrhagia or postmenopausal bleeding, it is important to consider in the assessment of a patient with abnormal (especially heavy) uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. Until relatively recently this condition was difficult to diagnose and management almost always required hysterectomy. Special investigations (hysteroscopy, Doppler flow ultrasound and pelvic angiography) are important for diagnosis and assessment. Transcatheter embolization has replaced hysterectomy as the treatment of choice in women who wish to retain their fertility. Curettage may precipitate life-threatening haemorrhage and is therefore contraindicated when uterine AVM is suspected.
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                Author and article information

                Journal
                Australas J Ultrasound Med
                Australas J Ultrasound Med
                10.1002/(ISSN)2205-0140
                AJUM
                Australasian Journal of Ultrasound in Medicine
                John Wiley and Sons Inc. (Hoboken )
                1836-6864
                31 December 2015
                May 2014
                : 17
                : 2 ( doiID: 10.1002/ajum.2014.17.issue-2 )
                : 72-74
                Affiliations
                [ 1 ]Peninsula Health Frankston VictoriaAustralia
                Author notes
                [*] [* ]Correspondence to email atrivedi@ 123456phcn.vic.giov.au
                Article
                AJUM00109
                10.1002/j.2205-0140.2014.tb00109.x
                5024942
                439f4318-ff1c-48fc-9033-d2047b9c4366
                © 2014 Australasian Society for Ultrasound in Medicine
                History
                Page count
                Figures: 0, Tables: 1, References: 10, Pages: 3
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                AJUM00109
                May 2014
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.4 mode:remove_FC converted:05.09.2016

                endometrial vascularity,doppler,secondary postpartum haemorrhage

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