Comparison of ultrasonography and Doppler ultrasonography of uterine AVM and RPOC in post-pregnancy early bleeding

Abstract

Late onset bleeding after pregnancy is commonly followed by miscarriage, vaginal delivery, cesarean section and curettage. The most common cause of these early hemorrhages is the presence of retained products of conception (RPOC) and the less common cause of AVM formation in the uterus. Due to the importance of this issue, in this study, vascular findings of gray scale and Doppler ultrasound, including the presence and volume of myometrial mass, vascular mass enhancement, PSV and RI of endometrial mass were evaluated and compared to determine which of the above findings in AVM detection is more sensitive and specific. Methods: 65 patients were studied in this study. At first, serum beta-hCG serum levels of patients were extracted and recorded. Transvaginal and Doppler ultrasonography was performed on all patients and the following were recorded: volume and position of endometrial mass, presence or absence of obvious vascular enhancement in Doppler, PSV mass in pulsed Doppler, RI mass in pulsed Doppler, then patients in two groups: 1- with beta-hCG positive, assuming the presence of RPOC and 2- with beta-hCG negative, assuming the presence of AVM and were evaluated for the above variables. In this way, it was determined how sensitive and specific each of the variables is to differentiate AVM from RPOC. Results: In this study, a total of 65 patients were studied, of which 28 patients were diagnosed with AVM and 37 patients with RPOC. In the present study, the mean endometrial mass in AVM group was 14.47 ± 12.14 cc. There was one case of myometrial mass with a volume of 5 cc. The mean endometrial mass in RPOC group was 18.35 15 15.59 cc and endometrial mass was 9.14 ± 5.84 cc. the mean resistance index in the AVM group was 0/41±0/1and in the residual group Pregnancy was equal to 0/46±0/11. The mean PSV in the AVM group was 42/35±15/11cm / sec and in the pregnancy residue group was 39/28±12/12cm / sec. In this study, mean vascular signal was highest in both AVM and RPOC groups, but clearly high vascular signal was higher in AVM group and there was a statistically clear difference between them.