ABSTRACT
Arterio-Venous Malformations (AVMs) are high flow vascular anomalies, commonly seen in head, neck and extremities. AVMs represent a direct connection between the arterial and the venous systems. They are congenital, often asymptomatic and rarely manifest before adolescence. Depending on the site, size and symptoms, treatment options varies from conservative management to surgical resection. Here, we report a case of 20-year-old male patient with long standing lump in the anterior abdominal wall with no typical clinical features of vascular lesions. However, imaging findings were suggestive of vascular malformation, and final histopathological examination revealed arterio-venous malformation.
ABSTRACT
Mechanical valve thrombosis is a life-threatening event, while pregnancy is associated with a hypercoagulable state. Thus, in pregnant women with mechanical valves, adequate anticoagulation becomes even more critical. This prospective study was conducted to establish a uniform anticoagulation regimen for these women. A total of 250 pregnancies in 245 women with mechanical heart valves were evaluated. The patients were divided into 2 groups: group 1 (n = 150) took oral warfarin throughout pregnancy and group 2 (n = 100) received subcutaneous heparin in the 1(st) trimester and oral warfarin for the other trimesters. Both groups received heparin at the time of delivery. There were no coumarin-induced fetal malformations. Minor thromboembolic episodes took place in 5 women in group 1 and 3 in group 2. Valve thrombosis occurred in 1 woman in group 2 and led to 1 maternal death in this series. The incidence of spontaneous abortion was similar between the groups. We conclude that warfarin is safe and convenient to use during pregnancy. The teratogenic effects of warfarin during the 1(st) trimester are overstated, and switching to heparin is not mandatory.
