Reframing the arteriovenous malformation paradigm: A case supporting conservative management of enhanced myometrial vascularity after uterine instrumentation

The diagnostic term acquired uterine arteriovenous malformation has come under scrutiny in the last several years as we learn more about the pathophysiology of uterine vasculature remodeling associated with pregnancy. The newer diagnostic term enhanced myometrial vascularity describes the ultrasonographic features that are seen in the myometrium surrounding pregnancy. As the terminology evolves, so too should our treatment. This case of a 32-year-old G2P1011 presenting with enhanced myometrial vascularity 3 months after dilation and evacuation for a second trimester twin pregnancy loss advocates for a conservative approach to treatment while avoiding the risks of the conventional treatment of uterine artery embolization.