Forceps delivery after molar malignancy in a woman with arteriovenous malformation. A case report.
BACKGROUND
An arteriovenous (AV) fistula in the female pelvis is a rare finding. This report describes a successful pregnancy after selective embolization of a postmolar vascular malformation.


METHODS
At 5 weeks of pregnancy, a 27-year-old, white female, gravida 3, para 0, was discovered on ultrasound examination to have an AV malformation along with a fetal pole. The patient was asymptomatic and had previously received two courses of chemotherapy for a previous nonmetastasized malignant molar pregnancy. Doppler ultrasonography uncovered a vascular malformation extending from the margin of the fetal pole to the margin of the uterus. The pregnancy ended at 8 weeks with a spontaneous abortion. The patient underwent angiography and embolization of extensive right-sided uterine vessels. She resumed normal menstrual periods six weeks after the embolization and became pregnant. The pregnancy concluded in low forceps vaginal delivery of a healthy, female infant at 34 weeks.


CONCLUSIONS
Vaginal delivery following postmolar pregnancy and a uterine AV malformation may be considered a viable delivery option.
Kelly
F W
FW
Wyoming County Department of Health, Warsaw, New York, USA.
D000328:Adult; D001165:Arteriovenous Malformations / Q000209:etiology* / Q000628:therapy*; D004621:Embolization, Therapeutic; D005113:Extraction, Obstetrical; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000150:complications*; D007231:Infant, Newborn; D009772:Obstetrical Forceps; D011247:Pregnancy; D011256:Pregnancy Outcome; D014594:Uterine Neoplasms / Q000150:complications*; D014599:Uterus / Q000002:abnormalities* / Q000098:blood supply*