A case of natural conception after uterine artery embolization
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20204840Keywords:
Arteriovenous malformation, Menorrhagia, Uterine artery embolizationAbstract
Our objective of this case report is to highlight the value of uterine artery embolization as a means of conservative management of uterine arteriovenous malformation in patients wanting preservation of fertility. A 24 years old woman, P1L1A2 presented with complaints of heavy menstrual bleeding for two months. She had a previous term caesarean section in 2014, followed by curettage twice, in 2016 and 2017. The first episode of heavy bleeding occurred two months after the last curettage. Previous menstrual cycles were regular with moderate flow. The patient was started on combined oral contraceptive pills but she did not respond to medical treatment. Transvaginal scan and Doppler showed uterine AVM and endometrial thickness of 7.7mm. Beta hCG was less than 1.2. Digital subtraction angiography and bilateral uterine artery embolization was done. Patient conceived spontaneously a year after the procedure and delivered a healthy baby at term by elective caesarean section. Angiography and uterine artery embolization has revolutionized the management of AVM and contrary to popular belief, the pregnancy outcome after UAE was good.
References
Evans A, Gazaille RE, McKenzie R, Musser M, Lemming R, Curry J, et al. Acquired uterine arteriovenous fistula following dilatation and curettage: an uncommon cause of vaginal bleeding. Radiology case reports. 2017;12(2):287-91.
Kaump GR, Spies JB. The impact of uterine artery embolization on ovarian function. Journal of Vascular and Interventional Radiology. 2013; 24(4):459-67.
Chen LK, Yang BL, Chen KC, Tsai YL. Successful transarterial embolization of uterine arteriovenous malformation: report of three cases. Iranian Journal of Radiology. 2016;13(1), e15358
Timor-Tritsch IE, Haynes MC, Monteagudo A, Khatib N, Kovács S. Ultrasound diagnosis and management of acquired uterine enhanced myometrial vascularity/arteriovenous malformations. American journal of obstetrics and gynecology. 2016;214(6):731-e1.
Yoon DJ, Jones M, Al Taani J, Buhimschi C, Dowell JD. A systematic review of acquired uterine arteriovenous malformations: pathophysiology, diagnosis, and transcatheter treatment. American Journal of Perinatology Reports. 2016;6(01):e6-14.
Chapman DR, Lutz MH. Report of successful delivery after nonsurgical management of a choriocarcinoma-related pelvic arteriovenous fistula. Am J Obstet Gynecol. 1985;153:155-7.
Eling R, Kent A, Robertson M. Pregnancy after uterine arteriovenous malformation-case series and literature review. Australasian journal of ultrasound in medicine. 2012;15(3):87-96.
