Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries

Abstract

The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication.

Uterine arteriovenous malformation with repeated vaginal bleeding after dilatation and curettage

“…Even though GTD was a less possible diagnosis, GTD should be considered in the differential diagnosis. If GTD was not ruled out definitively, methotrexate could be applied prophylactically via intramuscular injection [ 5 ].…”

Transcatheter arterial embolization for the management of persistent metrorrhagia secondary to uterine arteriovenous malformation

“…They can be congenital or acquired, in most cases, they are acquired secondary to pelvic surgery, curettage, intrauterine devices, gynecological tumors, trophoblastic disease, prolonged exposure to synthetic estrogens, or infectious processes 2,3 . It should be mentioned that uterine AVMs are closely related to pregnancy because the malformation appears when the venous sinuses are incorporated into the scar of the myometrium after the necrosis of the chorionic villi secondary to intrauterine procedures or changes related to pregnancy [3][4][5][6] . Uterine AVMs are generally asymptomatically.…”

“…Clinically, patients present with chronic anemia, sustained secondary hypotension, or even with low cardiac output syndrome. Few patients rarely experience abdominal pain, polyuria, dyspareunia, pulsatile mass, or heart failure [2][3][4]7 .…”

“…The main complications are non-selective embolization, with uterine necrosis, abscess formation, and ovarian failure. Other minor complications are hematoma and pain at the puncture site 1,3,4,[8][9][10] . Vaginal bleeding, chronicity, and hemodynamic status of the patient should always be taken into account; in such cases, emergency surgery would be the option.…”

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

“…[29][30][31] In cases of detecting after embolization, a circular localized lesion representing intravascular embolism is often observed. [32][33][34] In addition, the presence of necrotic membranes may be considered a risk factor for UAVM associated with the recent pregnancy of the patient. 9,35,36…”