Selective Arterial Embolisation of Uterine Arteriovenous Malformation in an Infertile Patient, subsequent Term Pregnancy and Postpartum Recurrence

J Coll Physicians Surg Pak. 2022 Feb;32(2):239-241. doi: 10.29271/jcpsp.2022.02.239.

Abstract

Uterine arteriovenous malformation (AVM) is a rare entity. This report describes selective catheterisation and embolisation of a uterine AVM in an infertile woman, subsequent spontaneous pregnancy and postpartum recurrence of the AVM treated with a second embolisation procedure. A 22-year woman presented with menometrorrhagia and failure to conceive. Pelvic magnetic resonance imaging showed a large uterine AVM. Selective catheterisation and embolisation of the AVM was performed. The patient conceived spontaneously two months later and delivered vaginally. A second embolisation was performed due to recurrence of uterine AVM at six months postpartum. This is the first case reporting postpartum recurrence of a pre-conceptionally treated uterine AVM. Selective catheterisation and embolisation is a minimally-invasive, fertility-preserving procedure that successfully treats uterine AVM and should be the treatment of choice when the patient desires pregnancy. Successful pregnancy and vaginal delivery following embolisation is possible; however, an increased awareness of postpartum AVM recurrence is required. Key Words: Fertility, Pregnancy, Therapeutic embolisation, Uterus, Arteriovenous malformation.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Malformations* / complications
  • Arteriovenous Malformations* / diagnostic imaging
  • Arteriovenous Malformations* / therapy
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Infertility, Female* / etiology
  • Infertility, Female* / therapy
  • Postpartum Period
  • Pregnancy
  • Uterus / diagnostic imaging