Subinvolution of the placental site.

J Ultrasound Med

Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr, H-1307, Stanford, CA 94305-5105, USA.

Published: August 2009

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http://dx.doi.org/10.7863/jum.2009.28.8.1115DOI Listing

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Article Synopsis
  • Uterine arteriovenous malformations (UAVMs) are a rare cause of heavy bleeding after childbirth, often linked to placenta accreta spectrum (PAS).
  • A case study highlighted a woman with PAS who experienced significant bleeding post-delivery and required several treatments, including uterine artery embolization, which proved effective.
  • The study suggests that UAVMs may arise from residual PAS tissue and emphasizes the importance of preserving fertility while managing severe bleeding, avoiding more drastic measures like hysterectomy.
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Article Synopsis
  • A new biologic treatment, Prevention-N-A, was tested for calves and shown to be effective compared to the older PS-2 preparation, significantly reducing gynecological issues in pregnant cows.
  • Three injections of the biologics improved reproductive health, decreased complications post-calving, and allowed for earlier heat cycles and better fertility rates.
  • In calves, the treatment also boosted growth and development, leading to heavier weights and fewer illnesses compared to untreated peers.
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The proper evaluation of abortion specimens and placentas from stillbirth and post-partum cases is important for adequate clinical care of post-abortion and post-partum patients. The following topics will be reviewed: (1) the importance of evaluation of both fetal and placental tissue in first trimester abortions to confirm an intrauterine pregnancy versus an ectopic pregnancy; (2) the clinical history associated with an abortion specimen or retained products of conception (POC) influences how the pathologist should triage the specimen; (3) the criteria for diagnosis of a molar pregnancy, which is critical for clinicians to know which patients need follow-up; (4) the utility of genetic studies for both diagnosis and appropriate follow-up of the patient; and (5) the pathologic evaluation of specimens from patients with post-partum hemorrhage for placenta accreta spectrum and subinvolution of maternal vessels.

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Aim: Abnormal uterine vascular pattern can be observed during transvaginal ultrasound examination used for investigating post-abortion bleeding and secondary postpartum hemorrhage. The purpose of this series of cases was to evaluate almost all the rare causes of uterine vascular abnormalities linked to pregnancy complications, and determine how to arrive at the diagnosis to optimize patient management, which is crucial for preventing life-threatening massive vaginal bleeding.

Material And Methods: Retrospective observational case series study including 20 women with postpartum or post-abortion vaginal bleeding who were found to have an abnormal uterine vascular pattern during a transvaginal color duplex assessment.

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Background: Delayed postpartum hemorrhage is rare, with an incidence of 0.5% to 2.0% in all pregnancies.

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