Uterine arteriovenous malformations associated with pregnancy: An uncommon cause of severe uterine bleeding / 대한산부인과학회지

ABSTRACT

Uterine arteriovenous malformations are considered very rare conditions, potentially life-threatening lesions combined with various degrees of menorrhagia, postpartum bleeding, postmenopausal bleeding, an asymptomatic mass, and congestive heart failure. Clinical suspicion is essential for a prompt diagnosis and treatment. They may be diagnosed by gray-scale ultrasonography and Color Doppler imaging. Additionally, they can be detected using contrast material-enhanced computed tomography (CT), conventional angiography, hysteroscopy and hysterosalpingogram. More recently, diagnosis of uterine AVM with magnetic resonance imaging (MRI) has been reported. In the past, laparotomy with uterine artery ligation or hysterectomy was the only treatment available. However, successful conservative management with embolization of the affected vessels or methylergonovine maleate has been reported recently. A 37-year-old woman, gravida 3, para 1, presented with massive uterine bleeding that started abruptly four weeks after D and C. We promptly performed non-invasive diagnositic evaluations including color Doppler, MRI and MRA, with a clinical impression of uterine AVM. In this case, we describe the appropriate diagnosis and management of uterine AVMs with literatures.