Ectopic pregnancy after successful treatment with percutaneous transcatheter uterine arterial embolization for congenital uterine arteriovenous malformation: a case report.
BACKGROUND
Uterine arteriovenous malformation (AVM) is a rare disease. Percutaneous transcatheter uterine arterial embolization (UAE) has been performed in patients who wish to preserve their ability to conceive. UAE is considered to be a safe and effective procedure, but its long-term effect on fertility has not been fully elucidated. We present a case of ectopic tubal pregnancy after conservative treatment with UAE for uterine AVM.


METHODS
A 30-year-old Japanese woman was admitted for the treatment of unruptured right tubal pregnancy at 6 weeks of gestation. She had conceived spontaneously and delivered a healthy baby at term, 3 years previously. Subsequently, she was successfully treated with UAE for a large congenital uterine AVM. Transvaginal color Doppler ultrasonography revealed no evidence of residual AVM vessels. After the diagnosis of ectopic pregnancy, the patient underwent right tubectomy. At laparotomy, there were no adhesions or structural anomalies in the pelvic cavity that might affect tubal function. The patient's postoperative course was uneventful, and she is now healthy without conception 24 months after surgery.


CONCLUSIONS
Prior uterine arterial embolization may have affected the tubal function in the present case, allowing tubal pregnancy to occur.
Nasu
Kaei
K
Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-machi, Yufu-shi, Oita 879-5593, Japan. nasu@med.oita-u.ac.jp
Nishida
Masakazu
M
Yoshimatsu
Jun
J
Narahara
Hisashi
H
D000328:Adult; D001165:Arteriovenous Malformations / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000209:etiology* / Q000601:surgery; D014591:Uterine Diseases / Q000151:congenital / Q000628:therapy*; D014599:Uterus / Q000098:blood supply*