{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T22:25:19Z","timestamp":1787091919404,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"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;amp; Gyne"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the role of circulating human chorionic gonadotropin (hCG) in the pathophysiology of enhanced myometrial vascularity (EMV) postpregnancy and the usefulness of determining hCG level in the clinical evaluation and management of this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective observational case series of patients managed clinically at our centers who had postpregnancy EMV diagnosed using\u00a0ultrasound by the observation of a dilated vascular web in the myometrium, with or without retained products of conception (RPOC), that persisted beyond 4\u20136\u2009weeks following a failed or terminated pregnancy. We retrieved serial maternal serum hCG measurements and noted the highest maternal serum hCG level measured, as well as the time for hCG to reach non\u2010pregnancy levels, defined as hCG \u2264\u20095\u2009mIU\/mL. The time to resolution of the EMV was recorded; this was determined by normal ultrasound findings (when imaging was available), or assumed if a procedure had been performed to resolve the EMV or when hCG reached non\u2010pregnancy levels. When available, we retrieved peak systolic velocity (PSV) values measured in the vascular web. A PSV of \u2265\u200920\u2009cm\/s was considered elevated. Representative ultrasound and color Doppler images were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen patients with sonographically diagnosed EMV that was still present over 4\u20136\u2009weeks after failure or termination of a pregnancy (i.e. persistent EMV) were included. The median duration from diagnosis of EMV until resolution was 113 (range, 58\u2013293)\u2009days. Persistence of EMV was associated with prolonged detectable levels of hCG, with a time for hCG to reach non\u2010pregnancy levels of 97 (range, 58\u2013271)\u2009days. In the 13 cases in which this was measured, Doppler studies revealed elevated PSV, with a median highest PSV of 80.8 (range, 46.7\u2013146.3)\u2009cm\/s. One patient was managed expectantly from the outset of their presentation. Four additional patients were followed expectantly for the EMV after they underwent\u00a0surgical procedures at presentation; seven patients required uterine artery embolization and four required dilatation and curettage to remove the residual placental tissue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings suggest that pathological persistence of EMV is associated with the prolonged presence of circulating hCG, probably produced by residual trophoblastic tissue. Furthermore, we believe that persistent EMV is potentially maintained, in major part, by the vasodilatory and angiogenic effects of circulating hCG. Recognition of this association provides a physiological explanation for the natural history of EMV and supports expectant management in hemodynamically stable patients. Monitoring of maternal serum hCG and Doppler PSV may help to distinguish self\u2010resolving EMV from cases requiring intervention, and high PSV levels can alert the practitioner to the potential for hemorrhage following intervention. These findings highlight the importance of differentiating EMV from congenital arteriovenous malformation and RPOC without EMV, and may inform more tailored, less invasive clinical management strategies. \u00a9 2026 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70266","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:01:19Z","timestamp":1782777679000},"page":"241-247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of human chorionic gonadotropin and post\u2010pregnancy persistent enhanced myometrial vascularity"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9774-3107","authenticated-orcid":false,"given":"I. E.","family":"Timor\u2010Tritsch","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7000-4582","authenticated-orcid":false,"given":"A.","family":"Monteagudo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai  New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. D.","family":"Platt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA, Center for Fetal Medicine and Women's Ultrasound  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. M.","family":"Shwayder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Florida  Gainesville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Maymon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shamir Medical Center, Gray Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Rosner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Johns Hopkins Center for Fetal Therapy  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-7737","authenticated-orcid":false,"given":"E.","family":"Jauniaux","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Fetal Medicine University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21872"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16646"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27476"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00443-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.05.044"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1637570"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1897564"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2024.07.038"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.12.024"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature10144"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004240051143"},{"issue":"2","key":"e_1_2_7_13_1","first-page":"651","article-title":"The expression of human chorionic gonadotropin\/luteinizing hormone receptors in human endometrial and myometrial blood vessels","volume":"75","author":"Lei ZM","year":"1992","journal-title":"J Clin Endocrinol Metab"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.01.063"},{"issue":"3","key":"e_1_2_7_15_1","first-page":"201","article-title":"Serial color Doppler flow of uterine vasculature combined with serum beta\u2010hCG measurements for improved monitoring of patients with gestational trophoblastic disease","volume":"42","author":"Maymon R","year":"1996","journal-title":"A preliminary report. 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