This paper presents the case of vaginal bleeding after medical termination of pregnancy (MTP) that is unresponsonsive to standard therapy.  The diagnosis of AV malformation is made at ultrasound, but a hysterectomy is required to stop life-threatening hemorrhage.  In general, this case was handled to a high international standard of care only if the patient did not desire future childbearing.  No mention of childbearing desires is made in the case presentation.  Optimal care would likely have minimized blood transfusions, also.

The point regarding a negative urine pregnancy test to rule out molar pregnancy is good, but explanation of the low level positive was not addressed, until the path returned products of conception.

The diagnosis of AV malformation is in doubt since pathology failed to reveal such structure.  Indeed, Jain and Fogata in 2007 described retained POC minicking AVM (J Clin Ultrasound 2007 jan; 35(1):42-7.  More detail should be given to convince the reader this indeed was an AVM.

The text should describe the optimal way to assess bleeding after 2 D+C, then how to avoid multiple transfusions prior to hysterectomy.

The sentence with the phrase "received 3 units of blood" is duplicated and this should be corrected.

Professor of Obstetrics and Gynecology at University of Vermont.  Clinician and academic researcher.

post abortion AV malfortion of the uterus is a common cause of abnormal uterine bleeding now a days. failure to available medical management results in lifesaving hystrectomies even in younger patients.minimal invasive surgeries like embolisation etc are other options for the treatment of this condition. there is need for trial of some other drugs so that this condition can be managed conservatively. 

10 years