**Core Concept**
Menorrhagia in a woman with a history of previous uterine surgery and a submucous myoma suggests a possible cause of the menstrual irregularities. Submucous myomas are a type of uterine fibroid that grows into the uterine cavity, potentially affecting menstrual flow and fertility.

**Why the Correct Answer is Right**
The best management option for this patient would be a surgical approach to remove the submucous myoma, as it is likely contributing to her menorrhagia. A myomectomy, which involves the surgical removal of the fibroid while leaving the uterus intact, is a suitable option for this patient. This procedure can be performed via laparotomy or minimally invasive techniques such as laparoscopy or hysteroscopy.

* **Option A:** Medical management with hormonal therapies such as gonadotropin-releasing hormone agonists (GnRHa) or progestins may provide temporary relief from menorrhagia but is not a definitive treatment for submucous myomas.
* **Option B:** Hysterectomy, which involves the removal of the entire uterus, is a definitive treatment for menorrhagia but is not the best option for this patient, as she is young and has a history of previous uterine surgery.
* **Option C:** Uterine artery embolization (UAE) is a minimally invasive procedure that can reduce blood flow to the fibroid, shrinking its size and alleviating symptoms. However, it may not be as effective as surgical removal and is associated with potential complications.

**Clinical Pearl / High-Yield Fact**
The American College of Obstetricians and Gynecologists (ACOG) recommends that women with submucous myomas and symptoms of menorrhagia or infertility undergo surgical removal of the fibroid (myomectomy) as the first-line treatment.

**Correct Answer: D.**