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Acquired AVM after uterine curettage: Reviewed literature
1 Assistant Professor, Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India
2 Dir. Professor, Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi, India
3 Specialist, Obstetrics & Gynecology, Lok Nayak Hospital, New Delhi, India
Address correspondence to:
Poonam Kashyap
Assistant Professor, Obstetrics & Gynecology, Maulana Azad Medical College, New Delhi,
India
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Article ID: 100069Z08PK2021
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Kashyap P, Kumar A, Sahu L, Sethi C. Acquired AVM after uterine curettage: Reviewed literature. J Case Rep Images Obstet Gynecol 2021;7:100069Z08PK2021.ABSTRACT
Uterine arteriovenous malformations (AVMs) are conditions which can lead to life-threatening hemorrhages. These are abnormal connections between arteries and veins, either from birth or develop after trauma. These are commonly associated with prior pregnancy and can be confused with retained products of conception. We present two cases of acquired uterine AVM with prior history of curettage done for incomplete abortion and presented with heavy vaginal bleeding. A 32-year-old lady with history of previous two caesarean section and two dilatation and curettage was referred with complaints of intermittent heavy vaginal bleeding and suspicion of AVM on Doppler study. She was diagnosed with uterine AVM by transvaginal color Doppler ultrasonography and three-dimensional computed tomography (3D-CT) angiography which demonstrated hypervascular bundles of uterine vessels, dilated draining veins, and feeding arteries. The dynamic magnetic resonance angiography (MRA) revealed early filling of the internal iliac vein and the inferior vena cava, indicating massive arteriovenous shunting in the uterus. The patient was treated with transcatheter bilateral uterine artery embolization and after the procedure, it was confirmed that the shunting of blood was reduced. The patient had resumed normal menstrual cycles after the procedure and remained fine in follow-up.
In another case, a 30-year-old lady was presented with irregular heavy vaginal bleeding, with previous two vaginal deliveries and history of curettage for incomplete abortion. She was diagnosed with uterine AVM with Doppler imaging and with CT angiography of pelvis. She was treated with transcatheter uterine artery embolization.
Keywords: Arteriovenous malformation, Magnetic resonance angiography, Transcatheter uterine artery embolization
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Author Contributions
Poonam Kashyap - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ashok Kumar - Substantial contributions to conception and design, Acquisition of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Latika Sahu - Revising it critically for important intellectual content, Final approval of the version to be published
Chetna Sethi - Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Poonam Kashyap et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
