Ultrasonographic indications for conservative treatment in pregnancy-related uterine arteriovenous malformations

Authors
Tae Young LeeSee Hyung KimHee Jung LeeMi Jeong KimSang Kwon LeeYoung Hwan KimSeung Hyun Cho
Department
Dept. of Radiology (영상의학)
Issue Date
2014
Citation
Acta Radiologica, Vol.55(9) : 1145-1152, 2014
ISSN
0284-1851
Abstract
Background: Uterine arteriovenous malformations (AVMs) are known to spontaneously regress. Purpose: To assess the predictive value of ultrasonography for patients requiring conservative treatment for pregnancy related to AVMs. Material and Methods: Our prospective study included 75 patients (conservative management:therapeutic management ¼45:30) with vaginal bleeding from pregnancy-related AVM. Clinical and ultrasonography examinations were reviewed, and the following information was gathered: complete blood count, AVM maximal diameter, AVM echogenicity, retained product of conception, number of blood vessels, and spectral Doppler (pulsatility index [PI], resistance index [RI], peak systolic velocity [PSV], time-averaged maximum velocity [TAMXV]). The Doppler criteria by Timmerman (mean PSV >70 cm/s: therapeutic management, mean PSV<52 cm/s: conservative management) were used for the initial management selection. The association between experimental variables and outcomes was assessed to determine their usefulness for predicting conservative management. Results: Features strongly associated with conservative management and their accuracy were PSV 89.6%, hemoglobin 84.7%, RI 83.1%, TAMXV 79.3%, and PI 78.6%. The overall accuracy for correct outcome classification was 64 (85.3%) of 75 patients. Most patients with conservative management had quicker improvement of symptoms and spontaneous regression at follow-up. Conclusion: Ultrasonography can accurately predict selection of conservative management. Keywords Arteriovenous malformations (AVMs), uterus, ultrasonography Date received: 10 June 2013; accepted: 4 November 2013
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34860
Appears in Collections:
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
Keimyung Author(s)
김시형; 이희정; 김미정; 이상권; 김영환
Full Text
http://journals.sagepub.com.proxy.dsmc.or.kr/doi/abs/10.1177/0284185113514222?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed
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