Presentation
Lower abdominal pain after miscarriage one month ago, with no history of uterine instrumentation.
Patient Data
Multiple serpiginous vascular channels are seen at the uterine fundus.
Color Doppler revealed turbulent flow with low resistance waveform (RI 0.3-0.4).
Thickened endometrium.
Appearances are consistent with enhanced myometrial vascularity.
Follow up after 7 weeks
Total regression of the previously seen enhanced myometrial vascularity.
Case Discussion
Enhanced myometrial vascularity (EMV) is frequently misdiagnosed as a uterine arteriovenous malformation (AVM) and often thus treated with uterine artery embolization, which may lead to ovarian insufficiency. Thus, conservative management with watchful waiting should be considered instead, particularly in women in the childbearing period.
This patient presented with lower abdominal pain one month after miscarriage with no surgical interference, consistent with a history of EMV which is typically seen as a complication of pregnancy. 7 weeks later the EMV disappeared spontaneously. A true AVM will not spontaneously regress.