{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:44:36Z","timestamp":1790063076073,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,4,5]],"date-time":"2024-04-05T00:00:00Z","timestamp":1712275200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the ultrasonographic, epidemiological, clinical and evolutive characteristics of enhanced myometrial vascularity (EMV) following a first\u2010trimester termination of pregnancy (TOP) or management of non\u2010viable pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study included women who underwent follow\u2010up ultrasound examination 5\u20136\u2009weeks after a first\u2010trimester TOP or after management of a first\u2010trimester non\u2010viable pregnancy at the University Hospital Polyclinic San Martino of Genoa between March 2021 and March 2022. EMV was characterized using two\u2010 and three\u2010dimensional ultrasound and Virtual Organ Computer\u2010aided Analysis. Ultrasonographic diagnosis of EMV was made when an unusual, tortuous myometrial vessel structure, with high\u2010velocity blood flow, protruding towards the endometrium was observed, while an abnormal junctional zone, absent endometrial midline and heterogeneous endometrium supported the diagnosis. Patients with EMV underwent expectant management with planned ultrasonographic follow\u2010up every 2\u2009weeks until resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the study period, 305 women underwent TOP, of whom 132 attended the initial follow\u2010up 5\u20136\u2009weeks later, at which 52 were diagnosed with EMV. Ninety\u2010six women were managed for a non\u2010viable pregnancy, of whom 32 presented for follow\u2010up, at which six had a diagnosis of EMV. Thus, overall, 164 of 401 women were included in the study and EMV was identified in 58 (35%) of these. The prevalence of EMV 5\u20136\u2009weeks after a TOP was therefore between 52\/305 (17%) and 52\/132 (39%), and that after management of a non\u2010viable pregnancy was between 6\/96 (6%) and 6\/32 (19%). Bleeding\/pelvic pain was present in half (29\/58) of the women with EMV, and serum human chorionic gonadotropin was detectable in 29% (17\/58) at the first follow\u2010up examination. At ultrasound assessment, all cases with EMV presented abundant tortuous myometrial vessels with high\u2010velocity flow projecting from the myometrium towards the endometrium, along with non\u2010uniform heterogeneous endometrium in 97% of cases, which often (67% of these) contained cystic areas, absence of the endometrial midline in 98% of cases and an abnormal junctional zone in 97% of cases (64% interrupted, 33% irregular). Most (67%) women with EMV were parous and 90% of them had undergone TOP rather than management for a non\u2010viable pregnancy. Medical management of the TOP or non\u2010viable pregnancy was more frequent in women with than those without EMV (93%\n                      <jats:italic>vs<\/jats:italic>\n                      77%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.023). Multiple regression analysis showed the risk of EMV to be increased following TOP\n                      <jats:italic>vs<\/jats:italic>\n                      non\u2010viable pregnancy (odds ratio (OR), 3.67 (95%\u2009CI, 1.16\u201311.56),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.026) and in parous compared with nulliparous women (OR, 2.95 (95%\u2009CI, 1.45\u20136.01),\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). All women with EMV underwent expectant management. Eleven women did not return for subsequent follow\u2010up examinations and did not present to our outpatient or emergency facilities, so were lost to further follow\u2010up. Spontaneous resolution of the lesion was observed within 7\u201316\u2009weeks after the procedure in 96% (45\/47) of the remaining cases. Two women chose to undergo surgery for pelvic discomfort, and histology showed the presence of neovessels mixed with retained chorionic villi.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EMV is a transient and common finding 5\u20136\u2009weeks following first\u2010trimester TOP or management of non\u2010viable pregnancy. TOP and being parous are risk factors for EMV. Expectant management of EMV is appropriate, because, in almost all cases, this resolves spontaneously, without complications, within 2\u20134\u2009months. \u00a9 2023 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.27537","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T17:03:30Z","timestamp":1700586210000},"page":"672-682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical and ultrasonographic characteristics of pregnancy\u2010related enhanced myometrial vascularity: prospective cohort study"],"prefix":"10.1002","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8887-3823","authenticated-orcid":false,"given":"A.","family":"Xholli","sequence":"first","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0989-8123","authenticated-orcid":false,"given":"U.","family":"Scovazzi","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6429-1220","authenticated-orcid":false,"given":"A. P.","family":"Londero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Paudice","sequence":"additional","affiliation":[{"name":"Department of Pathology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"University of Genoa  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Vacca","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. G.","family":"Schiaffino","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kratochwila","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Cavalli","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Perugi","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2714-623X","authenticated-orcid":false,"given":"A.","family":"Cagnacci","sequence":"additional","affiliation":[{"name":"Academic Unit of Obstetrics and Gynecology IRCCS Ospedale Policlinico San Martino  Genoa Italy"},{"name":"Department of Neurology, Rehabilitation, Ophthalmology, Genetics Maternal and Infant Health (DINOGMI)  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Collaborators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21872"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000183684.67656.ba"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1783\/jfp.34.2.118"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2020.1798905"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.333125177"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-016-0954-x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2021.02.028"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10051084"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.963"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/beog.2000.0136"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2021.12.001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2008.27.3.357"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.159"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.024"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.18954"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.15.14.10050"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2021.05.097"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.48095\/cccg2022249"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2018.05.001"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2019.10.011"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.11.006"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2007.00745.x"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7487"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14806"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5391"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20779"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2004.23.3.371"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.11.011"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2015.10.007"}],"container-title":["Ultrasound in Obstetrics &amp; 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