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Published on: September 5, 2011
[Acquired uterine arteriovenous malformations]
L Vandenbroucke1, K Morcel, B Bruneau
1Pôle de gynécologie, obstétrique et médecine de la reproduction, service d'obstétrique, CHU Anne-de-Bretagne, 16 boulevard de Bulgarie, Rennes cedex 2, France. laurent.vandenbroucke@yahoo.fr
Abstract:
Uterine arteriovenous malformations (AVM) may be responsible for vaginal bleeding potentially life-threatening. They are most often acquired following uterine trauma (curettage, cesarean section, artificial delivery/uterus examination) in association with pregnancy or gestational trophoblastic disease. We report three cases of patients having uterine AVM after curettage. The diagnostic management is important to avoid differential diagnoses (intra-uterine retention, hemangioma, gestational trophoblastic disease). It is based on serum hCG measurement and Doppler ultrasound, then confirmed on dynamic angio-MRI, which tends to replace angiography as first-line. The therapeutic management in cases of symptomatic AVMs is mostly embolization which offers the possibility for childbearing. Current data on subsequent pregnancies is reassuring even if they remain limited.
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