Embolization of uterine arteriovenous malformation for treatment of menorrhagia.
BACKGROUND
Uterine arteriovenous malformations are rare but potentially life-threatening conditions that should be suspected in unexplained severe vaginal bleeding.


METHODS
A 28-year-old gravida 7, para 3 presented to the emergency department with heavy vaginal bleeding and passage of blood clots. In the emergency room, her hemoglobin dropped from 11.2 to 7.4 gm%. Transvaginal ultrasonographic scan showed a large vascular mass in the uterus measuring 2.6 cm in diameter with low resistance of flow within, concerning for arteriovenous malformation or an arteriovenous fistula. Digital subtraction arteriography confirmed the lesion. She underwent angiography and bilateral uterine artery embolization.


CONCLUSIONS
The diagnosis of uterine arteriovenous malformation requires a high index of suspicion in the scenario of unexplained severe vaginal bleeding. Digital subtraction angiography is the gold standard for definitive diagnosis and allows immediate treatment by embolization.
Patel
Sapna
S
Department of Obstetrics/Gynecology, Temple University School of Medicine, Philadelphia, PA 19140, USA.
Potti
Sushma
S
Jaspan
David
D
Dandolu
Vani
V
D000328:Adult; D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000209:etiology / Q000628:therapy*; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*