Goyal Surbhi, Goyal Ankur, Mahajan Surbhi, Sharma Shikha, Dev Geeta
Department of Pathology, University College of Medical Sciences (UCMS) and Guru Teg Bahadur Hospital, Delhi, India.
J Obstet Gynaecol Res. 2014 Jan;40(1):271-4. doi: 10.1111/jog.12139. Epub 2013 Sep 5.
Abnormal uterine bleeding in the postabortal period requires meticulous diagnostic work-up to decide proper management. Imaging modalities including Doppler sonography and magnetic resonance imaging in concert with clinical and laboratory findings are useful to narrow the differential diagnoses but are not definitive. Presence of increased uterine vascularity and arteriovenous shunting is non-specific and can be detected in a variety of conditions including retained trophoblastic tissue, gestational trophoblastic disease, arteriovenous malformation (AVM), placental polyp and vascular neoplasm. We present here a case of a multiparous woman with unexplained postabortal bleeding posing a diagnostic challenge. Excluding the possibility of AVM before attempting dilatation and curettage in such a clinical scenario is crucial to prevent catastrophic bleeding.
流产后异常子宫出血需要进行细致的诊断检查以确定恰当的治疗方案。包括多普勒超声和磁共振成像在内的影像学检查方法，结合临床和实验室检查结果，有助于缩小鉴别诊断范围，但并非确诊依据。子宫血管增多和动静脉分流的表现并无特异性，在多种情况下均可检测到，包括残留的滋养层组织、妊娠滋养细胞疾病、动静脉畸形（AVM）、胎盘息肉和血管肿瘤。我们在此介绍一例经产妇出现不明原因的流产后出血，这给诊断带来了挑战。在这种临床情况下，尝试刮宫术前排除AVM的可能性对于预防灾难性出血至关重要。
