Vascular malformations in the uterus: ultrasonographic diagnosis and conservative management

Objective: To investigate the presence and outcome of uterine vascular malf ormations in women with abnormal premenopausal bleeding. Study design: In t his observational study 265 consecutive patients with abnormal premenopausa l bleeding were examined by the same ultrasonographer with transvaginal gra y-scale ultrasonography and color Doppler imaging. A final diagnosis of ute rine vascular malformation was based on ultrasonographic findings, hysteros copy or histological findings. Patients suspected of uterine vascular malfo rmations at ultrasonography were closely monitored. Results: In nine patien ts (3.4%) we found ultrasonographic features of uterine vascular malformati ons; Color Doppler imaging showed hypervascularity, marked turbulence, and low-impedance, high-velocity flow. In six patients the condition resolved s pontaneously. Two patients with hydatiform mole needed chemotherapy and the ir condition normalized. One patient underwent a selective embolization of the uterine artery. Subsequently, five patients had uncomplicated pregnanci es after resolution of the vascular malformation. Conclusion: Uterine vascu lar malformations are more common than previously thought. We conclude that conservative management is a valuable option in many of the acquired pregn ancy-related cases that are diagnosed with color Doppler imaging. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.