Uterine arteriovenous malformation — diagnosis and management

Abstract

Uterine arteriovenous malformations are uncommon but potentially life-threatening conditions. They can be congenital or acquired and should be suspected in cases of severe or persistent uterine bleeding. In recent years, there has been an in-creasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, caesarean delivery and curettage. This paper presents the review of the literature considered epidemiology, pathophysiology, diagnostic methods and treatment options. Unexplained uterine bleeding should be always an indication for colour Doppler ultrasonography and the presence of arteriovenous malformation should be always excluded.

Rare occurrence of uterine arteriovenous malformation clinically mimicking a malignant growth: A critical reminder for pathologists

“…Ultrasound with Doppler and Spectral analysis is the initial diagnostic tool to detect abnormal vascularity within the myometrium. 13 MRI and computed tomography (CT) are noninvasive approaches to confirm vascular abnormalities in conjunction with soft tissue assessment. 14 Digital subtraction CT angiography is currently the gold standard for diagnostic confirmation with the additional benefit of feeder vessels identification for embolization.…”

Successful transvenous embolization for type II uterine arteriovenous malformation: A case report

“…An acquired uterine arteriovenous malformation (U-AVM) is a rare condition causing uterine bleeding, menorrhagia, menometrorrhagia, lower abdominal pain, dyspareunia, or heart failure [1] . U-AVM often develops due to previous uterine trauma caused by dilatation and curettage (D&C), cesarean section, or pelvic surgery.…”

“…Several treatments, including transarterial embolization (TAE), have been reported for U-AVMs [1] . TAE is usually chosen as the first-line treatment due to its low invasiveness.…”

“…However, eliminating the vascular nidus (arteriole-venous connections without interposition of the normal capillary bed) of a huge or deeply involved U-AVM is difficult with TAE alone because the embolic material cannot sufficiently reach the nidus [3 , 4] . In cases where TAE results are inadequate, surgical treatment such as hysterectomy is preferred [1] . On the other hand, based on the anatomical morphology of AVMs in the body and extremities, treatment approaches other than TAE, such as nidus occlusion by transvenous or direct embolization, are proposed for complete occlusion [5 , 6] .…”

Uterine Arteriovenous Malformation Acquired after Cesarean Section: A Case Report

“…This condition is predominantly related to various forms of iatrogenic trauma such as hysteroscopy, curettage and myomectomy; even normal vaginal delivery could be traumatic enough to cause AVM. Endometrial carcinoma, cervical carcinoma and gestational trophoblastic disease could be other causes of AVM [1] [2]. The incidence and the prevalence are difficult to determine because it's often misdiagnosed with retained products of conception and placenta accreta [3].…”