A Case of Retained Products of Conception Adherent to the Caesarean Scar Site with AV Malformation Managed with Uterine Artery Embolisation

Retained products of conception (RPOC) and uterine arteriovenous malformations (AVM) are uncommon but serious causes of abnormal uterine bleeding (AUB). This case involves a 29-year-old woman, Para 2 Live 2, with a history of two caesarean sections and two previous abortions, who experienced heavy menstrual bleeding following medical termination of pregnancy (MTP) and tubectomy.Initially managed conservatively with methotrexate, she presented again a month later with recurrent AUB.Ultrasound and Doppler imaging revealed a thickened endometrium with significant vascularity, indicating RPOC and uterine AVM.Her -HCG levels were elevated (47.13) but trended downward upon repeat testing.Based on interventional radiology advice, she underwent bilateral uterine artery embolization (UAE) with gel foam.Following the procedure, the patient's symptoms improved significantly, with a noticeable reduction in both the frequency and intensity of her bleeding episodes.Her -HCG levels continued to decline, and no further episodes of heavy bleeding were noted during the one-month follow-up.This case highlights the diagnostic challenges associated with RPOC and uterine AVM, particularly after abortion.Doppler ultrasound plays a key role in detecting vascular abnormalities.Uterine artery embolization is an effective and safe first-line treatment, reducing hemorrhage risk and the need for hysterectomy.Early identification and intervention are critical to prevent life-threatening complications and ensure a favorable outcome.