Abstract：
Placenta accreta spectrum disorder (PAS) has an increased frequency due to the high number of cesarean sections. The abnormal placentation associated with a retained placenta can cause persistent uterine bleeding, with ultrasound Doppler examination being the main choice to assess the uterine hemorrhage. An acquired uterine arteriovenous malformation (AVM) may occur because of uterine trauma, spontaneous abortion, dilation and curettage, endometrial carcinoma or gestational trophoblastic disease. The treatment for abnormal placentation associated with AVM can be conservative, represented by methotrexate therapy, arterial embolization, uterine curettage, hysteroscopic loop resection or radical, which takes into consideration total hysterectomy. Therapeutic management always considers the degree of placental invasion, the patient hemodynamic state and fertility preservation. Considering the aspects described, we present a case of retained placenta percreta associated with acquired uterine AVM, with imagistic and clinical features suggestive of a gestational trophoblastic disease, successfully treated by hysterectomy, along with a small review of the literature, as only a few publications have reported a similar association of diagnostics and therapy.
摘要：
由于剖宫产次数过多，胎盘植入谱系障碍（PAS）的发生频率增加。与胎盘保留相关的异常胎盘可导致持续的子宫出血，超声多普勒检查是评估子宫出血的主要选择。获得性子宫动静脉畸形（AVM）可能是由于子宫外伤而发生的，自然流产,扩张和刮宫，子宫内膜癌或妊娠滋养细胞疾病。与AVM相关的异常胎盘形成的治疗可以是保守的，以甲氨蝶呤治疗为代表，动脉栓塞,刮宫术,宫腔镜环形切除术或根治性切除术，考虑到全子宫切除术。治疗管理总是考虑胎盘侵袭的程度，患者血流动力学状态及生育力保存。考虑到所描述的方面，我们介绍了一例与获得性子宫AVM相关的胎盘保留的病例，具有想象和临床特征，提示妊娠滋养细胞疾病，通过子宫切除术成功治疗，以及对文献的小评论，因为只有少数出版物报道了类似的诊断和治疗关联。
