Successful endovascular management of uterine arteriovenous malformation following cesarean section

Uterine arteriovenous malformations is rare case which cause secondary postpartum hemorrhage. This disor-der can cause massive and suddden vaginal bleeding. Despite of rare case, secondary arteriovenous malforma-tions can occur after a cesarean section. Patients who undergo uterine arteriovenous malformation generally have symptoms of menorrhagia or metrorrhagia after miscarriage, uterine surgery, including cesarean section, and curettage. In severe cases, this can lead to malformations of dyspnoea and heart failure. Management of AVM is by embolization, methotrexate treatment and hysterectomy depending on patient condition. Here reported a case of a patient aged 25 years with a diagnosis of P2H1, AUB ec AVM. Patients got history of caesarean section 6 months ago, and since 5 months ago patients were admitted 8 times for recurrent bleed-ing. Diagnostic examinations found AVM and hysterectomy was done. The AUB diagnosis in patients is less precise, the patient should be diagnosed with secondary postpartum hemorrhage due to uterine arteriovenous malformation acquired. Uterine arteriovenous malformation diagnosis should be considered in patients with secondary postpartum haemorrhage.Keywords: arteriovenous malformation, a former cesarean section, AUB

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P02.16: Selective transarterial embolization of uterine arteriovenous malformation complicated in previous Cesarean section scar pregnancy

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.8326 ◽

2010 ◽

Vol 36 (S1) ◽

pp. 174-174

Author(s):

Y. Kim ◽

H. Y. Ahn ◽

Y. Won ◽

T. Park ◽

S. Lee ◽

...

Keyword(s):

Cesarean Section ◽

Arteriovenous Malformation ◽

Transarterial Embolization ◽

Previous Cesarean Section ◽

Uterine Arteriovenous Malformation ◽

Previous Cesarean

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Trans-arterial embolization of acquired uterine arteriovenous malformation after Cesarean section: A case series

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v17i2.3991 ◽

2019 ◽

Vol 17 (2) ◽

pp. 135

Author(s):

Achmad Kemal Harzif ◽

Agrifa Haloho ◽

Melisa Silvia ◽

Gita Pratama ◽

Yuditiya Purwosunu ◽

...

Keyword(s):

Cesarean Section ◽

Arteriovenous Malformation ◽

Vaginal Bleeding ◽

Case Series ◽

Arterial Embolization ◽

Definitive Treatment ◽

Shock Condition ◽

First Choice ◽

Uterine Arteriovenous Malformation ◽

History Of

Background: Acquired uterine arteriovenous malformation (AVM) is a rare conditiondue to traumatic episodes in cesarean section. The patient can suffer from lifethreateninghemorrhage or recurrent vaginal bleeding. Establishing this diagnosis isdifficult, often misdiagnosed due to lack of information and number of cases. Trans-Arterial Embolization (TAE) procedure is rarely performed in our center. All of thecases were found with history of massive bleeding and diagnosed lately after recurrentbleeding history. Even though promising, one of our cases failed to be managed withTAE. It is important to diagnose early symptoms of AVM in order to prevent the lifethreatening event.Case presentation: In these case series, four cases of AVMs after cesarean procedureswill be reviewed. One could be diagnosed in less than a month but the other three tookseveral months. The symptom of vaginal bleeding might occur a few weeks after theprocedure is done, and most patients need transfusion and hospitalization. Three out offour patients were initially sent to the hospital in order to recover from shock condition,and one patient was sent for a diagnostic procedure. AVMs diagnostic was establishedwith ultrasound with or without angiography. Three of our cases were succeeded byperforming TAE procedure without further severe vaginal bleeding. One case failed tobe treated with embolization and had to proceed with hysterectomy.Conclusion: AVM should be considered early-on in patient with abnormal uterinebleeding and history of cesarean section. Embolization is still the first-choice treatmentof AVMs, otherwise definitive treatment is hysterectomy in a patient without fertilityneed, or impossible to perform TAE.

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