Successful Rx of Uterine AVM due to Uterine Trauma
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Uterine arteriovenous malformation (AVM) is defined as abnormal and nonfunctional connections between the uterine arteries and veins. These can be either congenital or acquired lesions (traumatic) lesions. Congenital AVMs are extremely rare conditions, whereas the incidence rate of acquired AVMs is currently increasing. Acquired AVMs are often associated with previous uterine surgery (dilation and curettage (D/C)), therapeutic abortion, cervix or endometrial cancer, trophoblastic diseases, and direct uterine trauma and occur more frequently in women at reproductive age. Typical symptom is vaginal bleeding; however, some patients may present with life-threatening massive bleeding.

We report a case of acquired AVM (after D/C) with an extensive lesion, which was successfully treated with UAE.

A 35-year-old patient, gravida 2, para 1, abortion 1, underwent D/C at nine weeks due to missed abortion about two weeks before in another center (Figure 1). The patient underwent repeat D/C procedure at control visit one week after initial intervention in another center with a suspected hematoma; however, the procedure had been discontinued due to hemorrhage and the patient was referred to our hospital. Upon admission, Hb was 11.2?g/dL, Htc was 35.1%, and hCG was 3518?mIU/mL. There was no evidence of active vaginal bleeding. Transvaginal ultrasonography (TVUSG) revealed a 60 × 60 × 56?mm (103?cm3) hyperechogenic and heterogeneous mass lesion located in the anterior wall of the uterus and extending laterally at the left. There was minimal fluid collection in the endometrial cavity.....