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Uterine Arteriovenous Malformation is Rare, but Life-Threatening Disease: A Report of 2 Cases

Bakisololo Miyuna Jacqueline; Wang Huali; Mbungu Mwimba Roger; Guan Linlin.

Abstract
Aim: Though uterine arteriovenous malformation (UAVM) is a rare event, it remains a life-threatening among reproductive women. Since its original description done by Dubreuil and Loubatin 1926; approximately 100 cases have been listed in the literature.
The aim of the present report is to state the effectiveness of uterine embolization in the management of UAVM.
Case Report: In this report, we present two patients with uterine arteriovenous malformation who were admitted for recurrent vaginal hemorrhage and treated twice to thrice, prior to confirm the diagnosis. These patients had a history of either cesarean or curettage. In addition, one of the cases (case number 2) had a previous conization for cervical intraepithelial neoplasia III (CINIII) one month earlier, which is an unusual case. The diagnosis has been made by color Doppler and Spectral flow imaging (CDFI) and Digital Subtraction Angiography (DSA). One of the patients was treated with embolotherapy, while another underwent a hysterectomy. The postoperative period was favorable.
Discussion: Although the uterine embolization being effective, the treatment of UAVM is not standardized. However, it depends on the clinical condition of the patient, desire of fertility and age.
Conclusion: The uterine arteriovenous malformation is a dangerous morbidity, which requires prompt diagnosis. Doppler ultrasound and MRI are non-invasive tools for the diagnosis. Furthermore, the uterine artery angiography remains the gold procedure of the diagnosis, concomitantly leads the procedure of the embolotherapy. The embolization of the UAVM has the advantage to preserve fertility. However, hysterectomy should be considered as the last option to save the patient’s life.

Key words: Arteriovenous malformation;Cesarean;Curettage;Vaginal bleeding


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