Figure 2.

A 31-year-old female who suffered a miscarriage at ten weeks gestation and underwent an evacuation of retained products of conception (ERPC) with two liters of blood loss intraoperatively. The patient reported ongoing per vaginal bleeding following this, with a significant drop in hemoglobin. Contrast enhanced CT (A,B) demonstrates multiple complex serpentine abnormal vessels in the uterus predominantly on the left side with intense enhancement during arterial phase and show early venous return, consistent with a uterine arteriovenous fistula (AVF). (C) Selective left uterine angiography confirms the AVF, drained by large bilateral gonadal veins. (D) The left uterine artery was embolized using Gelfoam pledgets, with good result.