{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T03:02:01Z","timestamp":1760151721287,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T00:00:00Z","timestamp":1649116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/diagnostics12040904","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T11:26:07Z","timestamp":1649157967000},"page":"904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retained Placenta Percreta with Acquired Uterine Arteriovenous Malformation\u2014Case Report and Short Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-145X","authenticated-orcid":false,"given":"Tudor","family":"Butureanu","sequence":"first","affiliation":[{"name":"Department of Mother and Child Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2875-8991","authenticated-orcid":false,"given":"Raluca Anca","family":"Balan","sequence":"additional","affiliation":[{"name":"Department of Morphofunctional Sciences I-Histology, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8969-8016","authenticated-orcid":false,"given":"Razvan","family":"Socolov","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolae","family":"Ioanid","sequence":"additional","affiliation":[{"name":"Department of Gynecologic Oncology, Regional Institute of Oncology, 2-4 G-ral Berthelot Str., 700483 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0979-0200","authenticated-orcid":false,"given":"Demetra","family":"Socolov","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dumitru","family":"Gafitanu","sequence":"additional","affiliation":[{"name":"Department of Mother and Child Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Ia\u015fi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,5]]},"reference":[{"key":"ref_1","first-page":"167986","article-title":"Retained Placenta Accreta Mimicking Choriocarcinoma","volume":"2015","author":"Kohi","year":"2015","journal-title":"Case Rep. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1097\/01.AOG.0000207559.15715.98","article-title":"Placenta previa, placenta accreta, and vasa previa","volume":"107","author":"Oyelese","year":"2006","journal-title":"Obstet. Gynecol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.2147\/IJWH.S224191","article-title":"Placenta Accreta Spectrum Disorders: Challenges, Risks, and Management Strategies","volume":"12","author":"Morlando","year":"2020","journal-title":"Int. J. Womens Health"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e6279","DOI":"10.1097\/MD.0000000000006279","article-title":"Management of patients with placenta accreta in association with fever following vaginal delivery","volume":"96","author":"Zhong","year":"2017","journal-title":"Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.ogc.2012.12.002","article-title":"Placenta accreta, increta, and percreta","volume":"40","author":"Wortman","year":"2013","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/S1701-2163(16)32401-X","article-title":"Diagnosis and management of placenta previa","volume":"29","author":"Oppenheimer","year":"2007","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/AOG.0b013e3182051db2","article-title":"Maternal Morbidity in Cases of Placenta Accreta Managed by a Multidisciplinary Care Team Compared With Standard Obstetric Care","volume":"117","author":"Eller","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1016\/j.placenta.2007.02.004","article-title":"In utero imaging of the placenta: Importance for diseases of pregnancy","volume":"28","author":"Abramowicz","year":"2007","journal-title":"Placenta"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1148\/rg.333125177","article-title":"Physiologic, histologic, and imaging features of retained products of conception","volume":"33","author":"Sellmyer","year":"2013","journal-title":"Radiographics"},{"key":"ref_10","first-page":"6437670","article-title":"Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management","volume":"2017","author":"Mekaru","year":"2017","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"554","DOI":"10.5468\/ogs.2016.59.6.554","article-title":"Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries","volume":"59","author":"Kim","year":"2016","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1148\/radiographics.22.1.g02ja0735","article-title":"Obstetric iatrogenic arterial injuries of the uterus: Diagnosis with US and treatment with transcatheter arterial embolization","volume":"22","author":"Kwon","year":"2002","journal-title":"Radiographics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.7863\/jum.2006.25.11.1387","article-title":"Uterine arteriovenous malformations: From diagnosis to treatment","volume":"25","author":"Neyastani","year":"2006","journal-title":"J. Ultrasound Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"419","DOI":"10.5468\/ogs.2014.57.5.419","article-title":"Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy","volume":"57","author":"Chang","year":"2014","journal-title":"Obstet. Gynecol. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1111\/jog.12390","article-title":"Sonohysterography is a useful diagnostic approach for uterine arteriovenous malformation","volume":"40","author":"Mishina","year":"2014","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1177\/0284185113514222","article-title":"Ultrasonographic indications for conservative treatment in pregnancy-related uterine arteriovenous malformations","volume":"55","author":"Lee","year":"2014","journal-title":"Acta Radiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s43055-021-00683-y","article-title":"Imaging spectrum of acquired uterine vascular abnormalities with angiographic correlates, a pictorial review","volume":"53","author":"Masood","year":"2022","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ejogrb.2014.07.023","article-title":"Uterine arteriovenous malformations following gestational trophoblastic neoplasia: A systematic review","volume":"181","author":"Touhami","year":"2014","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/j.1471-0528.2008.02037.x","article-title":"Optimal management strategies for placenta accreta","volume":"116","author":"Eller","year":"2009","journal-title":"Int. J. Obstet. Gynaecol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1016\/j.mayocp.2020.08.046","article-title":"Retained Products of Conception After Cesarean Section and Occult Placenta Accreta","volume":"95","author":"Schoolmeester","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s00404-017-4528-0","article-title":"Conservative endovascular management of retained placenta accreta with marked vascularity after abortion or delivery","volume":"296","author":"Takeda","year":"2017","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5387\/fms.2013-13","article-title":"Uterine artery embolization for uterine arteriovenous malformation is associated with placental abnormalities in the subsequent pregnancy: Two cases report","volume":"60","author":"Soeda","year":"2014","journal-title":"Fukushima J. Med. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1097\/AOG.0000000000000812","article-title":"Acquired Uterine Arteriovenous Malformation and Retained Placenta Increta","volume":"126","author":"Roach","year":"2015","journal-title":"Obstet. Gynecol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1016\/j.ajog.2011.01.001","article-title":"Arteriovenous malformation identification after conservative management of placenta percreta with uterine artery embolization and adjunctive therapy","volume":"204","author":"Barber","year":"2011","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_25","first-page":"1745506519878081","article-title":"Placenta accreta spectrum: Risk factors, diagnosis and management with special reference to the Triple P procedure","volume":"15","author":"Carrillo","year":"2019","journal-title":"Women\u2019s Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.ogc.2015.01.014","article-title":"Placenta accreta spectrum: Accreta, increta, and percreta","volume":"42","author":"Silver","year":"2015","journal-title":"Obstet. Gynecol. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kurman, R.J., Ellenson, L.H., and Ronnett, B.M. (2019). Diseases of the placenta. Blaustein\u2019s Pathology of the Female Genital Tract, Springer International Publishing AG. [7th ed.].","DOI":"10.1007\/978-3-319-46334-6"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/npmj.npmj_191_18","article-title":"Undiagnosed placenta praevia percreta: A rare case report and review of management","volume":"26","author":"Okunowo","year":"2019","journal-title":"Niger. Postgrad. Med. J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.ajog.2016.07.044","article-title":"Accreta placentation: A systematic review of prenatal ultrasound imaging and grading of villous invasiveness","volume":"215","author":"Jauniaux","year":"2016","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/ijgo.12408","article-title":"FIGO consensus guidelines on placenta accreta spectrum disorders: Prenatal diagnosis and screening","volume":"140","author":"Jauniaux","year":"2018","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.bpobgyn.2019.04.006","article-title":"New evidence-based diagnostic and management strategies for placenta accreta spectrum disorders","volume":"61","author":"Jauniaux","year":"2019","journal-title":"Best Pract. Res. Clin. Obstet. Gynaecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/ajo.12149","article-title":"Maternal outcome after conservative management of placenta percreta at caesarean section: A report of three cases and a review of the literature","volume":"54","author":"Pather","year":"2014","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/1471-0528.12524","article-title":"Surgical management of placenta accreta: To leave or remove the placenta?","volume":"121","author":"Wright","year":"2014","journal-title":"Int. J. Obstet. Gynaecol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1055\/s-0038-1669440","article-title":"Occult placenta accreta: Risk factors, adverse obstetrical outcomes, and recurrence in subsequent pregnancies","volume":"36","author":"Mullen","year":"2019","journal-title":"Am. J. Perinatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1055\/s-0035-1563721","article-title":"A Systematic Review of Acquired Uterine Arteriovenous Malformations: Pathophysiology, Diagnosis, and Transcatheter Treatment","volume":"6","author":"Yoon","year":"2016","journal-title":"AJP Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1046\/j.1469-0705.1997.10030215.x","article-title":"Color Doppler sonographic features of uterine arteriovenous malformations: Report of two cases","volume":"10","author":"Mungen","year":"1997","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1002\/uog.14628","article-title":"Prevalence of pelvic adhesions on ultrasound examination in women with a history of Cesarean section","volume":"45","author":"Moro","year":"2014","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_38","first-page":"293","article-title":"Pathophysiology of adhesions","volume":"109","author":"Butureanu","year":"2014","journal-title":"Chirurgia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.4103\/0366-6999.243570","article-title":"Clinical Characteristic and Management of Acquired Uterine Arteriovenous Malformation","volume":"131","author":"Zhu","year":"2018","journal-title":"Chin. Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1016\/j.radcr.2021.02.018","article-title":"Uterine arteriovenous malformations, clinical and radiological considerations: A report of two cases","volume":"16","author":"Nakashololo","year":"2021","journal-title":"Radiol. Case Rep."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2020144","DOI":"10.4322\/acr.2020.144","article-title":"Rare occurrence of uterine arteriovenous malformation clinically mimicking a malignant growth: A critical reminder for pathologists","volume":"10","author":"Lollie","year":"2020","journal-title":"Autops. Case Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1002\/uog.159","article-title":"Color Doppler imaging is a valuable tool for the diagnosis and management of uterine vascular malformations","volume":"21","author":"Timmerman","year":"2003","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1097\/AOG.0b013e318193bfdf","article-title":"Successful Bilateral Uterine Artery Embolization During an Ongoing Pregnancy","volume":"113","author":"Fox","year":"2009","journal-title":"Obstet. Gynecol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1097\/00004728-200301000-00016","article-title":"Retained Products of Conception Masquerading as Acquired Arteriovenous Malformation","volume":"27","author":"Kido","year":"2003","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ygyno.2004.05.013","article-title":"Diagnosis and treatment of gestational trophoblastic disease: ACOG Practice Bulletin No. 53","volume":"93","author":"Soper","year":"2004","journal-title":"Gynecol. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.tjog.2014.06.008","article-title":"Acquired uterine vascular abnormalities associated with persistent human chorionic gonadotropin: Experience at a Korean teaching hospital","volume":"54","author":"Ju","year":"2015","journal-title":"Taiwan J. Obstet. Gynecol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"147","DOI":"10.5582\/irdr.2015.01013","article-title":"Placental site trophoblastic tumor: A case report and literature review","volume":"4","author":"Zeng","year":"2015","journal-title":"Intractable Rare Dis. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1503\/cmaj.151481","article-title":"Persistent mild increase of human chorionic gonadotropin levels in a 31-year-old woman after spontaneous abortion","volume":"188","author":"Chen","year":"2016","journal-title":"Can. Med. Assoc. J."},{"key":"ref_49","first-page":"209","article-title":"Arteriovenous malformations of the uterus","volume":"73","author":"Fleming","year":"1989","journal-title":"Obstet. Gynecol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/s00404-011-2067-7","article-title":"Uterine arteriovenous malformations induced after diagnostic curettage: A systematic review","volume":"284","author":"Peitsidis","year":"2011","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1136\/ijgc-2021-002988","article-title":"Placenta increta mimicking placental site trophoblastic tumor","volume":"31","author":"Clark","year":"2021","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e2016.00109","DOI":"10.4293\/JSLS.2016.00109","article-title":"Hysteroscopic Management of Uterine Arteriovenous Malformation","volume":"21","author":"Calzolari","year":"2017","journal-title":"J. Soc. Laparoendosc. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.ygyno.2019.03.011","article-title":"Placental site trophoblastic tumor and epithelioid trophoblastic tumor: Clinical and pathological features, prognostic variables and treatment strategy","volume":"153","author":"Gadducci","year":"2019","journal-title":"Gynecol. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.ygyno.2009.10.056","article-title":"Placental site trophoblastic tumor: Lymphatic spread and possible target markers","volume":"116","author":"Lan","year":"2010","journal-title":"Gynecol. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/AOG.0b013e3181d066d4","article-title":"Maternal Outcome After Conservative Treatment of Placenta Accreta","volume":"115","author":"Sentilhes","year":"2010","journal-title":"Obstet. Gynecol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1080\/14767058.2019.1609935","article-title":"Use of routine ureteral stents in cesarean hysterectomy for placenta accreta","volume":"34","author":"Crocetto","year":"2021","journal-title":"J. Matern. Neonatal Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/904\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:48:47Z","timestamp":1760136527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/4\/904"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,5]]},"references-count":56,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["diagnostics12040904"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12040904","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2022,4,5]]}}}