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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objectives To assess the role of color flow Doppler ultrasonography (US) in the diagnosis of acquired uterine enhanced myometrial vascularities (EMV). Background EMV represents arteriovenous malformations that may be acquired after dilatation and curettage (D&C). Patients and methods This was a prospective study that included 107 patients presented with abnormal uterine bleeding, and after D&C, they were followed up to detect acquired EMV by using two-dimensional US and color flow Doppler. Results This study included 107 patients with age ranged between 18 and 59 years. The patients presented with intermittent or progressive vaginal bleeding owing to abortion (n = 95) (88.8%), dysfunctional uterine bleeding (n = 6) not controlled by medications, and secondary postpartum hemorrhage after caesarian section (n = 6). Two-dimensional ultrasonic picture of myometrial texture after D&C was done, and it showed heterogeneous lesion in 34 (31.8%) and homogeneous texture in 73 (68.2%) patients. The use of color power Doppler on suspected lesion showed high-velocity blood flow within the vascular 'web' with peak systolic velocity ranging from 16 to 48 cm/s in 24 (22.4%) patients and the resistance index recorded ranging from 0.28 to 0.79, with a mean of 0.56. The incidence of highly suggested EMV among 107 patients who had undergone dilation and curettage in the Department of Obstetrics and Gynecology in Menoufia University Hospital was 22.4%. Conclusion Routine gray-scale and color Doppler US evaluation of patients with early pregnancy failure or cesarean scar pregnancy is indicated to detect EMV as early as possible.

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