Diagnosis and management of uterine arteriovenous fistulas with massive vaginal bleeding.
OBJECTIVE
To study the clinical manifestations, diagnosis, management, and prognosis of uterine arteriovenous fistulas with massive vaginal bleeding.


METHODS
The clinical records of 15 patients who satisfied the diagnostic criteria were retrospectively analyzed.


RESULTS
All patients had massive vaginal bleeding and a history of cesarean section, curettage, or gynecologic carcinoma. The disease was diagnosed by angiography or color Doppler ultrasonography. Vaginal bleeding can be aggravated by dilation and curettage. No complications occurred in the 14 patients who were treated with uterine artery embolization. Of the 11 patients who underwent successful embolizations, all returned to a normal menstrual cycle and 5 later became pregnant.


CONCLUSIONS
Uterine arteriovenous fistula is a rare and potentially life-threatening condition. Uterine artery embolization is a safe and effective choice of treatment for this condition, and it can preserve both uterus and ovary function.
Yang
J J
JJ
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing 100730, China. yangjj@pumch.ac.cn
Xiang
Y
Y
Wan
X R
XR
Yang
X Y
XY
D000328:Adult; D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000628:therapy*; D002585:Cesarean Section / Q000706:statistics & numerical data; D004107:Dilatation and Curettage / Q000706:statistics & numerical data; D004621:Embolization, Therapeutic; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D005833:Genital Neoplasms, Female / Q000453:epidemiology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014592:Uterine Hemorrhage / Q000209:etiology / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*
D006490:Hemostatics; D011142:Polyvinyl Alcohol