Uterine arteriovenous malformation in pregnancy: A case report / Philippine Journal of Obstetrics and Gynecology

ABSTRACT

BACKGROUND: Uterine arteriovenous malformation (AVM) is a web of arteries and veins lacking an intervening capillary network. Color flow Doppler is a popular method of diagnosis of uterine AVM. The definitive management is hysterectomy. However, for patients desirous of pregnancy, transarterial embolization is a safe and effective option. Although rare, uterine AVM can complicate pregnancy with torrential bleeding due to hormonal changes and significant remodeling of the myometrium.CASE We report a case of a term pregnancyin a 33 year old with a uterine AVM and a previous transarterial embolization procedure who developed a uterine AVM during multi-agent chemotherapy for gestational trophoblastic disease. She consulted for prenatal checkup. Due to the risk of massive bleeding during labor, she underwent elective cesarean section at term and delivered a baby with good outcome.CONCLUSION: This case suggests that uterine AVM in pregnancy can be managed conservatively with serial ultrasound monitoring and close follow up.