Diagnosis and Nonsurgical Management of Uterine Arteriovenous Malformation

Abstract

Uterine arteriovenous malformation (AVM) is an uncommon problem and traditional treatment by hysterectomy excludes the possibility of future pregnancy. Developments in interventional techniques make transcatheter embolization of the feeding vessel(s) a therapeutic alternative, potentially preserving the patient's fertility. We present a case of successful endovascular treatment of uterine AVM.

A Systematic Review of Acquired Uterine Arteriovenous Malformations: Pathophysiology, Diagnosis, and Transcatheter Treatment

“…The presence of a tubular, hypoechogenic structure in the myometrium by grayscale ultrasound imaging, although common, is not specific for uterine AVM. The identification of uterine high velocity blood flow with low impedance by Doppler ultrasound is highly suggestive for a uterine AVM 44 54 ( Fig. 1a ).…”

“…MRI findings include serpiginous signal voids in the uterus and enhancement of the signal voids on rapid data acquisition during infusion of contrast. 54 55 56 MRI provides better tissue contrast and helps delineate the surrounding pelvic organ involvement. Acquired AVM primarily involves the myometrium while retained products of conception primarily involve the endometrium.…”

What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids?

“…Despite the emergence of new therapies, there is an unmet need for an effective non‐surgical treatment for uterine fibroids. The technique of UAE has been used for many years in the control of obstetric haemorrhage and more recently for the treatment of arteriovenous malformations 12 . In the last two decades, UAE is being increasingly used for the management of symptomatic uterine fibroids.…”

An Unusual Case of Acquired Uterine Arteriovenous Malformation With Persistent Scar Ectopic Pregnancy Successfully Managed With Uterine Artery Embolization

“…Thus, it is an important differential to be considered in patients presenting with unexplained vaginal bleeding. Chronic features include recurrent abortions and poor pregnancy outcome [3].…”