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Successful management of uterine arteriovenous malformation by laparoscopic bilateral uterine artery ligation

Katherine R. Matundan, MD; Nerissa Gracia G. Nano, MD, FPOGS and German C. Tan Cardoso II, MD, FPOGS
Department of Obstetrics and Gynecology, East Avenue Medical Center

Arteriovenous Malformations are vascular disorders where there is an abnormal communication between an artery and vein. It can occur anywhere in the body not even sparing the uterus. Uterine Arteriovenous Malformations (AV Malformation) is a rare occurrence with less than 100 cases reported in literature. It can cause significant bleeding leading to anemia and even hypovolemic shock. It may be acquired from previous uterine manipulation such as dilatation and curettage and previous uterine surgeries. Diagnosis is made by angiography or doppler ultrasonography. Definitive treatment is hysterectomy however a less invasive, fertility preserving are uterine vascular occlusion techniques, of which the treatment of choice is Uterine Artery Embolization (UAE). We present our experience with 24 year-old G2P2 (1101) with scarred uterus suffering from recurrent profuse vaginal bleeding suspected to have uterine arteriovenous malformation. Laparoscopic bilateral uterine artery ligation, an alternative, more economical, relatively safe and available treatment option was given to the patient.