A Rare Case of Uterine Arteriovenous Malformation after Dilatation and Evacuation

Abstract

Uterine arteriovenous malformation (AVM) is a rare cause of heavy and sometimes life-threatening vaginal bleeding. As name implies, uterine AVMs result from one or more sites of abnormal direct communication between an artery and a vein without an intervening capillary bed resulting in increased pressure and high-velocity flow, as well as marked vascular enlargement, in the venous system. The treatment of choice depends on the symptoms, age, desire for future fertility, localization, and size. This case report highlights our experience with a patient having acquired uterine AVM after dilatation and evacuation which was managed in our institute. Transvaginal scan of pelvis showed evidence of heteroechoic echogenic contents within the uterine cavity with few cystic spaces with increased vascularity on color Doppler. Computerized Tomography (CT) angiogram confirmed the diagnosis of AVM in endometrium and posterior myometrium with two arterial feeders and draining veins. Embolization of AVM was performed successfully and patient became asymptomatic post procedure and stopped bleeding per vaginum.