Placental Polyp with Suspected AVM Treated with Methotrexate Followed by Selective Embolization and Removal - A Case Report

A 28year old women (primigravida) underwent medical termination of pregnancy (MTP) at 21 weeks of gestation for fetal esophageal atresia. After 2weeks of MTP she experienced severe abdominal discomfort and came with USG showing retained products of conception and vascular mass in the uterine cavity. She was given injection Methotrexate intramuscularly in view of high vascularity of the mass with a plan for evacuation after reducing vascularity. On USG there was persistent vascularity and hence proceeded with MRI pelvis with MR angiogram. The presence of a placental polyp with arteriovenous malformation was suspected on MRI pelvis. The patient underwent a transfemoral angiogram and selective embolization of both uterine arteries followed by hysteroscopic evacuation of retained products of conception (RPOC).