TITLE:
Uterine Arteriovenous Malformation Acquired after Cesarean Section: A Case Report
AUTHORS:
Ana Lúcia Isotton, Leandro Armani Scaffaro, Ellen Machado Arlindo, Anne Bergmann, Nicolas Karpouzas Vicentini, Janete Vettorazzi
KEYWORDS:
Arteriovenous Malformation, Embolization Therapeutic, Vaginal Bleeding, Cesarean Section
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.11,
November
18,
2021
ABSTRACT: Background: Uterine arteriovenous malformation (AVM) is a rare,
potentially life-threatening cause of abnormal uterine bleeding that can be
acquired following a cesarean section. The diagnosis is difficult, often
misdiagnosed with retained products of conception and placenta accreta.
Transarterial embolization (TAE) is an efficacious
and effective method of treating AVM, particularly in patients of reproductive
age. Case Report: A 41-year-old, nulliparous woman, started with a history of abnormal uterine bleeding 30 days after a
cesarean section. She didn’t have anaemia and beta-human chorionic gonadotropin
(beta-hCG) was negative. The transvaginal color Doppler ultrasound showed
multiple vascular channels within myometrium showing colored mosaic patterns
suggesting AVM, confirmed by Magnetic Resonance Imaging. The patient was referred
to perform a Computed Tomography Angiography and right uterine artery
embolization without any vascular complications. Conclusion:
AVM is a rare consequence of cesarean section but has to be considered in cases
of persistent uterine bleeding in the puerperium. Embolization is a safe and
effective choice treatment of AVM and an alternative and less invasive option
for patients wishing to preserve fertility.