title: Disappearance of a uterine arteriovenous malformation following long-term administration of oral norgestrel/ethinyl estradiol.
abstract: Uterine arteriovenous malformation (AVM) can cause sudden massive hemorrhage. We report a case of uterine AVM following curettage in a patient treated conservatively with an intermediate-dose pill. An 18-year-old gravida 2 para 0 underwent curettage at 12 weeks of gestation and was examined for massive genital hemorrhage that occurred in postoperative month 4. Abundant blood flow in a mass within the uterine lumen was observed on color Doppler ultrasonography, and the patient was diagnosed with AVM. Six days after starting oral norgestrel/ethinyl estradiol, the hemorrhage ceased, and computed tomography on day 37 of administration showed disappearance of the abnormal vasculature. After 12 months, the patient's course remains favorable without relapse. Transarterial embolization for AVM can cause ovarian failure and subsequent placental malpositioning. Administration of oral norgestrel/ethinyl estradiol may be an alternative conservative treatment option for patients who wish to maintain fertility.
authors.affiliation: Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo, Shimane, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Oride
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kanasaki
authors.forename: Kohji
authors.initials: K
authors.lastname: Miyazaki
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects; D000293:Adolescent; D001165:Arteriovenous Malformations / Q000150:complications / Q000188:drug therapy*; D003280:Contraceptives, Oral, Synthetic / Q000008:administration & dosage*; D004997:Ethinyl Estradiol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009644:Norgestrel / Q000008:administration & dosage*; D055988:Uterine Artery / Q000002:abnormalities*; D014592:Uterine Hemorrhage / Q000209:etiology
chemical_list: D003280:Contraceptives, Oral, Synthetic; D009644:Norgestrel; D004997:Ethinyl Estradiol
keywords: arteriovenous malformation; conservative therapy; drug treatment; fertility; norgestrel/ethinyl estradiol