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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 January-February;179(1-2):79-84

DOI: 10.23736/S0393-3660.19.04026-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Uterine arteriovenous malformation: a rare cause of abnormal uterine bleeding

Joana COMINHO 1 , Inês AZEVEDO 1, Sofia SARAMAGO 1, Ana BRANDÃO 1, Isabel SERRANO 2, Helena SANTOS E PEREIRA 1, Filomena NUNES 1

1 Department of Obstetrics and Gynecology, Hospital de Cascais Dr. José de Almeida, Cascais, Portugal; 2 Department of Pathology, Hospital de Cascais Dr. José de Almeida, Cascais, Portugal



Uterine arteriovenous malformation (AVM) is an uncommon vascular disease which usually occur during reproductive age. It is a potentially life-threatening condition, as patient may present with profuse bleeding. Doppler ultrasound provides a noninvasive method for initially diagnosis, but the invasive angiography is the gold standard for confirmation. Conservative management or embolization are possible methods of management in order to avoid a hysterectomy in patients of child-bearing age. However, the definitive treatment is hysterectomy. A 32-year-old woman, gravida 3 para 2, presented in emergency department with profuse vaginal bleeding associated with mild pelvic pain. Pelvic ultrasonography revealed a left uterine AVM. After consideration of all treatment options, hysterectomy was performed. Uterine arteriovenous malformations should be included in the differential diagnosis of abnormal uterine bleeding. Color and spectral doppler can aid in diagnosis and clinical management. The treatment of uterine AVM depends on hemodynamic status, degree of bleeding, patient age and desire for future fertility.


KEY WORDS: Arteriovenous malformation; Uterine hemorrhage; Doppler ultrasonography; Uterine artery

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