"Enhanced myometrial vascularity is thought to represent low resistance high-velocity blood flow through modified peritrophoblastic spiral arteries 4. It can be seen in the setting of retained products of conception, gestational trophoblastic disease or placental site subinvolution (inadequate / delayed closure or sloughing of modified spiral arteries) 12,13. It is not considered a true arteriovenous malformation, which is defined as an abnormal anastomosis between an artery and vein that bypasses the capillary bed."
"Digital subtraction angiography (DSA) shows a hypervascular lesion without early venous filling. Conversely, a true uterine arteriovenous malformation will show a hypervascular mass with early venous filling 8,9."
"Dilation and curettage in the setting of retained products of conception remains a viable alternative which often leads to resolution of the enhanced myometrial vascularity. There is no increased risk of haemorrhage when compared to dilation and curettage of retained products of conception without enhanced myometrial vascularity, except in the cases of caesarean scar and molar pregnancies 2,6,11."
"Enhanced myometrial vascularity is almost exclusively seen in the context of recent pregnancy, and therefore occurs in women of reproductive age 4. It is typically secondary to retained products of conception in the early postpartum period, or following first-trimester miscarriage or termination of pregnancy 1,5,6. However, the incidence of enhanced myometrial vascularity following a first-trimester miscarriage is relatively low (1.5%) 1. There is also a high association with caesarean scar pregnancy and gestational trophoblastic disease 4."
"Dilation and curettage in the setting of retained products of conception remains a viable alternative which often leads to resolution of the enhanced myometrial vascularity. There is no increased risk of haemorrhage when compared to dilation and curettage of retained products of conception without enhanced myometrial vascularity, except in the cases of caesarean scar and molar pregnancies 2,6,11."