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Published on: October 20, 2017
A life-threatening event: uterine cervical arteriovenous malformation
Lior Lowenstein1, Ido Solt, Michael Deutsch
1Department of Obstetrics and Gynecology, Rambam Medical Center and the Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. l_lior@rambam.health.gov.il
Background:
Uterine cervical arteriovenous malformation is a rare cause of vaginal bleeding.
Case:
A 32-year-old multigravida presented with severe vaginal bleeding originating in the cervix, which resulted in a hypovolemic shock. Attempts to control the bleeding included hysterectomy, pelvic arterial embolization, and upper vaginectomy. Each proved unsuccessful. Histopathologic examination revealed an arteriovenous malformation. Despite local packing, suturing of the vault area, and brachytherapy to the vaginal vault, bleeding persisted. Treatment with GnRH agonist and tranexamic acid stopped the bleeding.
Conclusion:
Severe vaginal bleeding can be the result of cervical arteriovenous malformation, and GnRH agonist may be used for treatment.
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