Subinvolution of the placental site associated with focal retained products of conception and placenta accreta mimicking uterine arteriovenous malformation on CT and MRI: a lesson to be learned

摘要

Here, we report the case of a 36-year-old female patient (G5A4P1, undergoing cesarean section of twins) with a history of antiphospholipid antibody syndrome, gestational hyperten sion, and having undergone hysteroscopic procedures. On post partum day 12, there was voluminous vaginal bleeding. Given the diagnostic hypothesis of retained products of conception (RPOC)—based on the finding of serum b-HCG values close to zero—we opted for clinical follow-up with ultrasound evalua tions, which invariably showed a grossly nodular echogenic for mation, measuring 2.2 cm at its greatest diameter and located near the basal endometrium, with internal vascular flow seen on color Doppler (Figure 1A). After approximately 60 days, the condition of the patient had not improved and the decision to perform curettage was therefore made. During the procedure, she bled profusely (500 mL) and became hypotensive.