Uterine arteriovenous malformation with repeated vaginal bleeding after dilatation and curettage

Abstract

Uterine arteriovenous vascular malformation (UAVM) is a disease that causes excessive bleeding. The symptoms do not subside without proper treatment and this can lead to life-threatening situations. The correct diagnosis of UAVM can be complicated if the patient's uterus did not completely discharge everything during abortion (in broader terms, retaining remnants of the products of conception). In this case, Doppler ultrasonography and computed tomography angiography with 3-dimensional rendering were used to analyze the cause of bleeding and provide proper treatment of this patient. Then, uterine artery embolization, dilatation, and curettage were performed safely and successfully. The patient no longer had symptoms of vaginal spotting during the planned follow up care. UAVM is uncommon; however, if reproductive-age women show repeated abnormal vaginal bleeding after dilatation and curettage, a diagnosis of UAVM must be considered based on the medical history and examination.

Embolization of uterine arteriovenous malformation causing postpartum hemorrhage using n-butyl cyanoacrylate: A case report

“…The diagnosis of uterine AVM is typically made during angiography as part of a uterine artery embolization procedure for treatment of hemorrhage [1] . However, if a patient presents with the symptoms above, color Doppler ultrasonography could confirm the diagnosis of a uterine AVM noninvasively [5] . The use of ultrasound also allows the physician to evaluate for other entities that may cause similar symptoms, such as uterine fibroids, cancer, or endometrial hyperplasia.…”

“…The gold standard for diagnosis remains digital subtraction angiography of the uterine arteries due to its ability to identify the nidus of blood vessels and evaluate the size and flow of the arteriovenous shunt associated with the AVM [1] . For larger AVMs, CT angiography or MR angiography may be used to examine the full extent of the AVM for preprocedure planning [5] .…”

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

“…Reported complications include uterine infection, uterine ischemia, uterine necrosis, damage to other organs, and possible problems in future pregnancies (eg, abnormalities of the placenta). 1,9 Hysterectomy, the most common gynecologic procedure, also has its own complication, including infectious, venous thromboembolic, genitourinary and gastrointestinal tract injury, recurrent bleeding, and nerve injury. 84 Another concern is ovarian failure condition after the uterine arterial constriction.…”

“…Uterine arteriovenous malformation (UAVM) is a rare condition that may cause vaginal hemorrhage and possibly lead to a life-threatening state. 1 UAVM was first described by Dubreuil and Loubat in 1926. 2 It is classified as a congenital or acquired type and the latter accounts for the majority of cases.…”

“…UAVM is also a cause of recurrent miscarriages if not well controlled. 1,6,10 Furthermore, this rare entity has received much attention in the literature but is poorly understood, especially in terms of advanced imaging diagnosis, molecular medicine, and multimodal management combinations.…”