Presentation
Per vaginal bleeding.
Patient Data
Ultrasound of the uterus shows multiple anechoic tortous elongated structures at the anterior wall of the myometrium. On color Doppler, the anechoic areas show blood flow and aliasing.
Spectral Doppler (images unavailable) showed arterialization with a biphasic waveform.
Case Discussion
A young female presented with complaints of heavy per vaginal bleeding following dilation and curettage (D&C). On ultrasound examination, multiple dilated, tortuous anechoic areas at the anterior myometrial wall were observed.
Application of color Doppler revealed turbulent blood flow with aliasing. Spectral Doppler showed arterialization of waveform with a small systolic peak. This condition is called enhanced myometrial vascularity. The term "acquired arteriovenous malformation of the uterus" has fallen out of favor, as it is not a true arteriovenous malformation and therefore may be confusing. It typically occurs following D&C or an abortion. The peak systolic velocity is usually more than 20 cm/s, ranging up to 60 cm/s.
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