Ultrasonographic indications for conservative treatment in pregnancy-related uterine arteriovenous malformations
- Tae Young Lee; See Hyung Kim; Hee Jung Lee; Mi Jeong Kim; Sang Kwon Lee; Young Hwan Kim; Seung Hyun Cho
- Dept. of Radiology (영상의학)
- Issue Date
- Acta Radiologica, Vol.55(9) : 1145-1152, 2014
- 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.
Arteriovenous malformations (AVMs), uterus, ultrasonography
Date received: 10 June 2013; accepted: 4 November 2013
- Appears in Collections:
- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
- Keimyung Author(s)
- 김시형; 이희정; 김미정; 이상권; 김영환
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