Vol 89, No 5 (2018)
Review paper
Published online: 2018-05-30

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Uterine arteriovenous malformation — diagnosis and management

Agata Szpera-Goździewicz1, Karolina Gruca-Stryjak1, Grzegorz H. Bręborowicz1, Mariola Ropacka-Lesiak1
Pubmed: 30084480
Ginekol Pol 2018;89(5):276-279.

Abstract

Uterine arteriovenous malformations are uncommon but potentially life-threatening conditions. They can be congenital or acquired and should be suspected in cases of severe or persistent uterine bleeding. In recent years, there has been an in­creasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, caesarean delivery and curettage. This paper presents the review of the literature considered epidemiology, pathophysiology, diagnostic methods and treatment options. Unexplained uterine bleeding should be always an indication for colour Doppler ultrasonography and the presence of arteriovenous malformation should be always excluded.

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References

  1. Hoffman MK, Meilstrup JW, Shackelford DP, et al. Arteriovenous malformations of the uterus: an uncommon cause of vaginal bleeding. Obstet Gynecol Surv. 1997; 52(12): 736–740.
  2. Peitsidis P, Manolakos E, Tsekoura V, et al. Uterine arteriovenous malformations induced after diagnostic curettage: a systematic review. Arch Gynecol Obstet. 2011; 284(5): 1137–1151.
  3. Timmerman D, Wauters J, Van Calenbergh S, et al. Color Doppler imaging is a valuable tool for the diagnosis and management of uterine vascular malformations. Ultrasound Obstet Gynecol. 2003; 21(6): 570–577.
  4. O'Brien P, Neyastani A, Buckley AR, et al. Uterine arteriovenous malformations: from diagnosis to treatment. J Ultrasound Med. 2006; 25(11): 1387–92; quiz 1394.
  5. Kasznica J, Nisar N. Congenital vascular malformation of the uterus in a stillborn: a case report. Hum Pathol. 1995; 26(2): 240–241.
  6. Vijayakumar A, Srinivas A, Chandrashekar BM, et al. Uterine vascular lesions. Rev Obstet Gynecol. 2013; 6(2): 69–79.
  7. Aiyappan SK, Ranga U, Veeraiyan S. Doppler Sonography and 3D CT Angiography of Acquired Uterine Arteriovenous Malformations (AVMs): Report of Two Cases. J Clin Diagn Res. 2014; 8(2): 187–189.
  8. Clarke JA, Viswanatha RK, Hamid R, et al. Diagnosis and management of life-threatening hypermenorrhagia caused by uterine arteriovenous malformation secondary to surgical termination of pregnancy: video evidence! BMJ Case Rep. 2012; 2012.
  9. Fleming H, Ostör AG, Pickel H, et al. Arteriovenous malformations of the uterus. Obstet Gynecol. 1989; 73(2): 209–214.
  10. Brown JV, Asrat T, Epstein HD, et al. Contemporary diagnosis and management of a uterine arteriovenous malformation. Obstet Gynecol. 2008; 112(2 Pt 2): 467–470.
  11. Manolitsas T, Hurley V, Gilford E. Uterine arteriovenous malformation--a rare cause of uterine haemorrhage. Aust N Z J Obstet Gynaecol. 1994; 34(2): 197–199.
  12. Laing F, Frates M, Frates M. Ultrasound evaluation during the first trimester of pregnancy. In: Callen PW. ed. Ultrasonography in obstetrics and gynecology. 4th ed., Philadelphia 2000: Philadelphia.
  13. Dillon EH, Case CQ, Ramos IM, et al. Endovaginal US and Doppler findings after first-trimester abortion. Radiology. 1993; 186(1): 87–91.
  14. Kido A, Togashi K, Koyama T, et al. Retained products of conception masquerading as acquired arteriovenous malformation. J Comput Assist Tomogr. 2003; 27(1): 88–92.
  15. Timmerman D, Van den Bosch T, Peeraer K, et al. Vascular malformations in the uterus: ultrasonographic diagnosis and conservative management. Eur J Obstet Gynecol Reprod Biol. 2000; 92(1): 171–178.
  16. Maldonado J, Perez C, Rodriguez W. AJR Teaching File: Profuse vaginal bleeding seven weeks following induced abortion. AJR Am J Roentgenol. 2008; 191(6 Suppl): S79–S82.
  17. Grivell RM, Reid KM, Mellor A. Uterine arteriovenous malformations: a review of the current literature. Obstet Gynecol Surv. 2005; 60(11): 761–767.
  18. Vogelzang RL, Nemcek AA, Skrtic Z, et al. Uterine arteriovenous malformations: primary treatment with therapeutic embolization. J Vasc Interv Radiol. 1991; 2(4): 517–522.
  19. Alessandrino F, Di Silverio E, Moramarco LP. Uterine arteriovenous malformation. J Ultrasound. 2013; 16(1): 41–44.
  20. Bhoil R, Raghuvanshi V, Basavaiah S. A case of congenital uterine arterio-venous malformation managed by hysterectomy. Pol J Radiol. 2015; 80: 202–205.
  21. Wani NA, Shaheen F, Kousar T, et al. Uterine arteriovenous malformation diagnosed with multislice computed tomography: a case report. J Reprod Med. 2010; 55(3-4): 166–170.
  22. Gulati MS, Paul SB, Batra A, et al. Uterine arteriovenous malformations: the role of intravenous 'dual-phase' CT angiography. Clin Imaging. 2000; 24(1): 10–14.
  23. Hashim H, Nawawi O. Uterine arteriovenous malformation. Malays J Med Sci. 2013; 20(2): 76–80.
  24. Elia G, Counsell C, Singer SJ. Uterine artery malformation as a hidden cause of severe uterine bleeding. A case report. J Reprod Med. 2001; 46(4): 398–400.
  25. Maleux G, Timmerman D, Heye S, et al. Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy. Eur Radiol. 2006; 16(2): 299–306.
  26. Lim AKP, Agarwal R, Seckl MJ, et al. Embolization of bleeding residual uterine vascular malformations in patients with treated gestational trophoblastic tumors. Radiology. 2002; 222(3): 640–644.
  27. Hare WS, Holland CJ. Paresis following internal iliac artery embolization. Radiology. 1983; 146(1): 47–51.
  28. Chen Y, Wang G, Xie F, et al. Embolization of uterine arteriovenous malformation. Iran J Reprod Med. 2013; 11(2): 159–166.
  29. Poppe W, Van Assche FA, Wilms G, et al. Pregnancy after transcatheter embolization of a uterine arteriovenous malformation. Am J Obstet Gynecol. 1987; 156(5): 1179–1180.
  30. Gopal M, Goldberg J, Klein TA, et al. Embolization of a uterine arteriovenous malformation followed by a twin pregnancy. Obstet Gynecol. 2003; 102(4): 696–698.
  31. Vedantham S, Goodwin SC, McLucas B, et al. Uterine artery embolization: an underused method of controlling pelvic hemorrhage. Am J Obstet Gynecol. 1997; 176(4): 938–948.
  32. Khatree MH, Titiz H. Medical treatment of a uterine arteriovenous malformation. Aust N Z J Obstet Gynaecol. 1999; 39(3): 378–380.
  33. Ghosh TK. Arteriovenous malformation of the uterus and pelvis. Obstet Gynecol. 1986; 68(3 Suppl): 40S–43S.
  34. Milingos D, Doumplis D, Sieunarine K, et al. Uterine arteriovenous malformation: fertility-sparing surgery using unilateral ligation of uterine artery and ovarian ligament. Int J Gynecol Cancer. 2007; 17(3): 735–737.
  35. Seo KJ, Kim J, Sohn InS, et al. Failed transarterial embolization of subserosal uterine arteriovenous malformation. Obstet Gynecol Sci. 2013; 56(5): 333–337.