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Related Experiment Videos

Luna Fabricius Ekenberg1, Line Markdanner Lindgren1, Caroline Pehrson1

  • 1Gynækologisk-Obstetrisk Afdeling, Slagelse Sygehus.

Ugeskrift for Laeger
|June 7, 2024
PubMed
Summary
This summary is machine-generated.

A woman experienced severe vaginal bleeding after starting rivaroxaban for atrial fibrillation. Bilateral uterine artery embolization successfully stopped the life-threatening hemorrhage.

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Area of Science:

  • Cardiology
  • Gynecology
  • Interventional Radiology

Background:

  • Anticoagulant therapy with rivaroxaban is commonly prescribed for atrial fibrillation.
  • Menorrhagia, particularly in women with uterine fibromas, presents a significant clinical challenge.
  • Uncontrolled vaginal bleeding can be life-threatening, requiring prompt and effective intervention.

Observation:

  • A 44-year-old premenopausal woman presented with uncontrollable vaginal bleeding shortly after initiating rivaroxaban for atrial fibrillation.
  • Her medical history included menorrhagia attributed to an intrauterine fibroma.
  • Conservative medical management, including factor X supplementation, proved insufficient to control the hemorrhage.

Findings:

  • The patient's severe vaginal bleeding was refractory to non-surgical treatments.

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  • Bilateral embolization of the uterine arteries was performed to address the source of bleeding.
  • The uterine artery embolization procedure resulted in the cessation of vaginal hemorrhage.

    • Implications:

    • This case highlights a potential complication of rivaroxaban therapy in patients with pre-existing gynecological conditions.
    • Uterine artery embolization is an effective interventional treatment for life-threatening vaginal bleeding in select cases.
    • Careful patient selection and monitoring are crucial when prescribing anticoagulants to women with a history of menorrhagia or uterine fibromas.