A life-threatening event: uterine cervical arteriovenous malformation.
BACKGROUND
Uterine cervical arteriovenous malformation is a rare cause of vaginal bleeding.


METHODS
A 32-year-old multigravida presented with severe vaginal bleeding originating in the cervix, which resulted in a hypovolemic shock. Attempts to control the bleeding included hysterectomy, pelvic arterial embolization, and upper vaginectomy. Each proved unsuccessful. Histopathologic examination revealed an arteriovenous malformation. Despite local packing, suturing of the vault area, and brachytherapy to the vaginal vault, bleeding persisted. Treatment with GnRH agonist and tranexamic acid stopped the bleeding.


CONCLUSIONS
Severe vaginal bleeding can be the result of cervical arteriovenous malformation, and GnRH agonist may be used for treatment.
Lowenstein
Lior
L
Department of Obstetrics and Gynecology, Rambam Medical Center and the Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. l_lior@rambam.health.gov.il
Solt
Ido
I
Deutsch
Michael
M
Kerner
Hedviga
H
Amit
Amnon
A
D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage; D001165:Arteriovenous Malformations / Q000150:complications* / Q000628:therapy; D001918:Brachytherapy; D002584:Cervix Uteri / Q000098:blood supply*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008186:Luteolytic Agents / Q000008:administration & dosage; D013536:Suture Techniques; D014148:Tranexamic Acid / Q000008:administration & dosage; D017329:Triptorelin Pamoate / Q000008:administration & dosage; D014592:Uterine Hemorrhage / Q000209:etiology* / Q000628:therapy
D000933:Antifibrinolytic Agents; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D014148:Tranexamic Acid