Arteriovenous malformation as a consequence of a scar pregnancy.
A scar pregnancy is an ectopic pregnancy implanted in a previous lower segment cesarean scar, and the incidence of this complication may be expected to rise along with increasing cesarean section rates. Arteriovenous malformation of the uterus may be congenital, associated with early pregnancy loss, trophoblastic disease, or surgical procedures. We describe a case of uterine arteriovenous malformation as a consequence of a scar pregnancy, complicated by recurrent, serious bleeding. The condition was diagnosed using three-dimensional ultrasound with color Doppler and magnetic resonance imaging and appears not to have been described before. Selective embolization was performed, but eventually surgical intervention with resection of the affected uterine segment was necessary, and the patient recovered. The diagnosis was confirmed by pathologic-anatomical diagnosis showing trophoblastic cells in the resected area. Because of collateral formation, non-surgical options may be limited and not successful.
Rygh
Astrid B
AB
Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway. ryas@sus.no
Greve
Ole J
OJ
Fjetland
Lars
L
Berland
Jannicke M
JM
Eggebø
Torbjørn M
TM
D000328:Adult; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000209:etiology*; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000209:etiology*; D018615:Ultrasonography, Doppler, Color; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging