title: Ultrasonographic indications for conservative treatment in pregnancy-related uterine arteriovenous malformations.
abstract: BACKGROUND
  Uterine arteriovenous malformations (AVMs) are known to spontaneously regress.
  
  
  OBJECTIVE
  To assess the predictive value of ultrasonography for patients requiring conservative treatment for pregnancy related to AVMs.
  
  
  METHODS
  Our prospective study included 75 patients (conservative management:therapeutic management = 45:30) 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.
  
  
  CONCLUSIONS
  Ultrasonography can accurately predict selection of conservative management.
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea.
authors: Tae Young
authors: TY
authors: Lee
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea kseehdr@dsmc.or.kr.
authors: See Hyung
authors: SH
authors: Kim
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea.
authors: Hee Jung
authors: HJ
authors: Lee
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea.
authors: Mi Jeong
authors: MJ
authors: Kim
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea.
authors: Sang Kwon
authors: SK
authors: Lee
authors: Keimyung University, Dongsan Hospital, Department of Radiology, Republic of Korea.
authors: Young Hwan
authors: YH
authors: Kim
authors: Kyungbook National University Hospital, Department of Radiology, Republic of Korea.
authors: Seung Hyun
authors: SH
authors: Cho
mesh_terms: D000208:Acute Disease; D000328:Adult; D001165:Arteriovenous Malformations / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000000981:diagnostic imaging* / Q000628:therapy; D011446:Prospective Studies; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*
chemical_list: D015415:Biomarkers
keywords: Arteriovenous malformations (AVMs); ultrasonography; uterus