Immediate post‐partum haemorrhage caused by rupture of uterine arteriovenous malformation

Chien, Shih‐Chang; Tseng, Shei-Chain; Hwa, Hsiao‐Lin; Wei, Ming-Chow

doi:10.1111/j.1479-828x.2007.00729.x

Cited by 7 publications

(5 citation statements)

References 4 publications

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“…Primary survey of the abstracts and articles excluded 224 articles dealing with subjects other than transcatheter embolization, animal studies, reviews or articles in a non-English language. After critical evaluation of the remaining full text articles for acquired uterine AVMs, 40 articles remained for final inclusion meeting the minimum requirements above and comprised of 39 case reports 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 and one retrospective study. 41 The cumulative evaluated population comprised of 54 women with a mean age of 33.5 years.…”

Section: Resultsmentioning

confidence: 99%

“…Based on this literature search there has been no study comparing the efficacy of each embolic agent, or combinations of agents. Glue (seven cases [13%] [Ghai et al included four cases]), 6 27 31 41 Gelfoam (Pharmacia and Upjohn Company, Kalamazoo, MI) (seven cases [13%]), 7 9 12 25 32 38 41 coils (six cases [11%]), 2 8 10 18 20 21 polyvinyl alcohol (PVA) (six cases [11%]), 14 23 28 34 36 41 microspheres (five cases [9%] (Halperin et al included two cases)] 7 16 17 40 were the most commonly used embolic agents as single agents. There were 14 other combinations of embolic agents used in the literature ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

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

Yoon

Jones

Taani

et al. 2015

AJP Rep

103

184

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Objective An acquired uterine arteriovenous malformation (AVM) is a rare cause of vaginal bleeding and, although hysterectomy is the definitive therapy, transcatheter embolization (TCE) provides an alternative treatment option. This systematic review presents the indications, technique, and outcomes for transcatheter treatment of the acquired uterine AVMs. Study Design Literature databases were searched from 2003 to 2013 for eligible clinical studies, including the patient characteristics, procedural indication, results, complications, as well as descriptions on laterality and embolic agents utilized. Results A total of 40 studies were included comprising of 54 patients (average age of 33.4 years). TCE had a primary success rate with symptomatic control of 61% (31 patients) and secondary success rate of 91% after repeated embolization. When combined with medical therapy, symptom resolution was noted in 48 (85%) patients without more invasive surgical procedures. Conclusion Low-level evidence supports the role of TCE, including in the event of persistent bleeding following initial embolization, for the treatment of acquired uterine AVMs. The variety of embolic agents and laterality of approach delineate the importance of refining procedural protocols in the treatment of the acquired uterine AVM. Condensation A review on the management of patients with acquired uterine AVMs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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

Yoon

Jones

Taani

et al. 2015

AJP Rep

103

184

View full text Add to dashboard Cite

show abstract

“…Conversely, in patients with positive serum hCG levels even after 1 month after delivery, a placental polyp should be suspected [18] . Finally, for those patients with persistent high serum hCG levels, gestational trophoblastic disease and placental site trophoblastic tumor may be excluded [19] , [20] , [21] , [22] . In the past, the diagnosis of AVMs was often only histological after the discovery of arteriovenous fistula after hysterectomy [23] , [24] , [25] , but today, thanks to the advent of imaging modalities such as color Doppler ultrasound, magnetic resonance imaging, computed tomography and pelvic angiography, diagnosis is easier and possible earlier.…”

Section: Discussionmentioning

confidence: 99%

Uterine venous malformations in the puerperium: 2 Atypical cases and literature review

Damiani,

Dellino,

Cascardi

et al. 2023

European Journal of Obstetrics & Gynecology and Reproductiv

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“…The embolic agent most commonly used in patients desiring fertility is gelfoam because of its temporary nature ( 10 , 13 ) , but no difference is reported in clinical outcome with other embolic agents ( 14 , 9 ) .…”

Section: Discussionmentioning

confidence: 99%

Outcome in women undergoing uterine artery embolization for arterio-venous malformation diagnosed post-pregnancy-A retrospective study

Kulshrestha¹,

Shivhare²,

Meena³

et al. 2022

tjod

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Objective: To analyse the outcome of patients with symptomatic arterio-venous malformation (AVM), formed following pregnancy and managed by uterine artery embolization (UAE). Materials and Methods: This retrospective study was conducted after ethical approval and included 15 patients presenting with abnormal uterine bleeding following pregnancy, who were suspected to have an AVM which later was confirmed by angiography and managed with UAE. Presenting symptoms, post- UAE complications and subsequent fertility outcomes were noted. Follow-up period ranged from 6 months to 2.5 years. Results: The mean age was 28.4±3.82 years and mean parity was 1.3. Out of 15 cases, 9 (60%) presented after abortion, 4 (26.6%) after normal vaginal delivery and 2 (13.3%) after cesarean delivery; of these 10/15 (66.7%) patients had a history of curettage. The most common presenting symptom was continuous bleeding per-vaginum since the antecedent pregnancy in 9/15 (60%) patients and 6/15 (40%) patients had irregular bleeding. The mean duration of symptoms was 91±85.7 (30-360) days. For UAE, embolic agents used were polyvinyl alcohol (PVA) particles (300-500 μm) in 2 (13.3%), 30% glue injection in 3 (20%), the combination of PVA with glue injection in 4 (26.6%) and PVA with gelfoam in 6 (40%) patients. After UAE, bleeding responded within 3.6±0.97 (3-6) days in all but one patient who required repeat UAE one month later. All women resumed their normal menstrual cycle in 31.3±5.2 (24-42) days. Ten patients desired conception, of whom 5 (50%) conceived within 13.2±5.1 (6-19) months after UAE. Two women carried pregnancy to term, one underwent preterm cesarean for growth restriction with oligohydramnios. One patient had postpartum hemorrhage, which was managed medically. One had spontaneous abortion at 6 weeks gestation and the other is 13 weeks pregnant at present. Conclusion: UAE is an effective treatment modality for the management of symptomatic post-pregnancy AVMs.

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Immediate post‐partum haemorrhage caused by rupture of uterine arteriovenous malformation

Cited by 7 publications

References 4 publications

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

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

Uterine venous malformations in the puerperium: 2 Atypical cases and literature review

Outcome in women undergoing uterine artery embolization for arterio-venous malformation diagnosed post-pregnancy-A retrospective study

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