Resolution of uterine arteriovenous malformation and successful pregnancy after treatment with a gonadotropin-releasing hormone agonist.
BACKGROUND
Uterine arteriovenous malformations are a rare and potentially life-threatening condition. Medical therapy has not been popular because of the propensity for excessive bleeding in the patient. As a result, the effect of gonadotropin-releasing hormone (Gn-RH) agonists on uterine arteriovenous malformations has not been established.


METHODS
A 30-year-old patient presented with persistent vaginal bleeding. Based on the color Doppler ultrasound and magnetic resonance imaging findings, a uterine arteriovenous malformation was diagnosed. Because initial treatment with methylergonovine maleate was unsuccessful, the patient was treated with Gn-RH agonists. The lesion completely disappeared after 6 months of Gn-RH agonist treatment. Five months after the completion of Gn-RH agonist therapy, the patient conceived spontaneously and successfully completed a normal pregnancy. The patient has remained free from recurrence of the lesion.


CONCLUSIONS
Gonadotropin-releasing hormone agonist therapy has the potential to be a conservative treatment modality for uterine arteriovenous malformations in hemodynamically stable patients.
From the Division of Obstetrics and Gynecology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan.
Taro
T
Nonaka
Tetsuro
T
Yahata
Katsunori
K
Kashima
Kenichi
K
Tanaka
D000328:Adult; D001165:Arteriovenous Malformations / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008755:Methylergonovine / Q000627:therapeutic use; D011247:Pregnancy; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014592:Uterine Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects*
D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide; D008755:Methylergonovine
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