Uterine arteriovenous malformation complicating a scar ectopic pregnancy

Uterine arterio-venous malformation is characterized by abnormal direct arteriovenous communication without normal intervening capillary network. Acquired uterine arterio-venous malformation in post cesarean scar pregnancy is a rare entity. Classically the patients present with lower abdominal pain and per vaginal bleeding. Pelvic examination may reveal a pulsatile mass. Herein, we present a case of multiparous woman undergoing conservative treatment for caesarian scar pregnancy who presented with vaginal bleeding despite declining beta HCG levels. Review and update of recent literature regarding the diagnostic imaging of this entity are described.