title: Acquired uterine vascular abnormalities associated with persistent human chorionic gonadotropin: Experience at a Korean teaching hospital.
abstract: OBJECTIVE
  The aim of this study was to describe our experience with the diagnosis and management of acquired uterine vascular abnormalities associated with persistent human chorionic gonadotropin (hCG). Through this case series, we sought to establish our protocol for the treatment and follow-up of uterine vascular lesions associated with persistent hCG.
  
  
  METHODS
  We examined the clinical presentations of 28 Korean women with acquired vascular uterine abnormalities associated with persistent hCG who were seen in the Department of Obstetrics and Gynecology of the Gangneung Asan Teaching Hospital, Gangneung-si, Korea between October 2006 and July 2012 and retrospectively reviewed their medical records.
  
  
  RESULTS
  The mean patient age was 32.5 ± 6.4 years, and the mean parity was 1.4 ± 1.2. The mean size of the vascular lesions in color Doppler sonography and multidetector computed tomography with angiography was 3.1 ± 1.6 cm and 3.9 ± 1.6 cm, respectively. Multidetector computed tomography revealed arteriovenous malformation-like vascular lesions (n = 15) and pseudoaneurysms (n = 3). Treatments included clinical observation (n = 11), uterine artery embolization (n = 11), hysterectomy (n = 4), and chemotherapy, including single methotrexate (MTX) treatment and combination chemotherapy (n = 9).
  
  
  CONCLUSIONS
  When the uterine vascular lesion is not decreased, or if weekly clinical follow-up reveals that the serum β-hCG level is persistently elevated or sustained in conjunction with vaginal hemorrhage, a proper management strategy is required.
authors.affiliation: Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, South Korea.
authors.forename: Da Hye
authors.initials: da H
authors.lastname: Ju
authors.affiliation: Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, South Korea. Electronic address: buzzmi@naver.com.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Yi
authors.affiliation: Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, South Korea.
authors.forename: Woo Seok
authors.initials: WS
authors.lastname: Sohn
authors.affiliation: Department of Obstetrics and Gynecology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung-si, Gangwon-do, South Korea.
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000030:Abortion, Missed / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D000792:Angiography; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis / Q000628:therapy; D007044:Hysterectomy; D061330:Multidetector Computed Tomography; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000628:therapy; D056910:Republic of Korea; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D055988:Uterine Artery / Q000000981:diagnostic imaging; D055357:Uterine Artery Embolization; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000628:therapy; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D006063:Chorionic Gonadotropin
keywords: arteriovenous malformation; human chorionic gonadotropin; pseudoaneurysm; uterus