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Uterine Arteriovenous Malformation in Pregnancy: A Case Report

Jean Aileen M. Elauria, MD; Agnes L. Soriano-Estrella, MD, FPOGS, FPSSTD, MHPEd
Department of Obstetrics and Gynecology, Philippine General Hospital

Background. Uterine arteriovenous malformation (AVM) is a web of arteries and veins lacking an intervening capillary network. Color flow Doppler is a popular method of diagnosis of uterine AVM. The definitive management is hysterectomy. However, for patients desirous of pregnancy, transarterial embolization is a safe and effective option. Although rare, uterine AVM can complicate pregnancy with torrential bleeding due to hormonal changes and significant remodeling of the myometrium.

Case. We report a case of a term pregnancyin a 33 year old with a uterine AVM and a previous transarterial embolization procedure who developed a uterine AVM during multi-agent chemotherapy for gestational trophoblastic disease. She consulted for prenatal checkup. Due to the risk of massive bleeding during labor, she underwent elective cesarean section at term and delivered a baby with good outcome.

Conclusion. This case suggests that uterine AVM in pregnancy can be managed conservatively with serial ultrasound monitoring and close follow up.