Arteriovenous malformations of the uterus: long-term follow-up

Arteriovenous malformations (AVMs) of the uterus have various clinical presentations. With the advancement of and accessibility to imaging, the diagnosis of the lesions in association with less severe clinical presentations is becoming more common. Contrary to cases with severe hemorrhage, the management of these cases is not clear. The purpose of this study was to describe our experience with diagnosis, management and long-term follow-up of cases with different clinical presentations of uterine AVMs.

The clinical and sonographic presentations of 8 cases diagnosed between July 2000 and July 2003 in our medical center are described. Annual sonographic follow-up was performed for a period of at least 42 months.

Only 3 of the 8 cases presented with heavy vaginal bleeding and 2 of them required selective embolization. Two patients had hysterectomy during the study period which was not related to a severe bleeding event. Long-term follow-up for all other cases was significant for sonographic resolution of the uterine AVM.

Management of uterine AVMs should be influenced by the clinical and not by the sonographic findings. If clinically feasible, conservative management should be considered as the primary approach, since most of these lesions tend to spontaneously resolve.