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- W4387260287 abstract "Uterine AVM is a rare, life-threatening condition of abnormal myometrial vascular communication. It can present with acute episodes of heavy bleeding and hemorrhage. The treatment depends on hemodynamic stability and desired future fertility. This case describes the management of persistent bleeding in the setting of a delayed diagnosis of an AVM after a possible Caesarean scar pregnancy. The patient is a 31-year-old female with a prior Caesarean section, who was diagnosed with an 8-week missed abortion located near her prior scar. She failed medical management twice. She then presented with a septic abortion and underwent a D&C. Two weeks later, she had persistent bleeding, and a sonogram revealed a “heterogenous vascular region in anterior myometrium.” She was diagnosed with a degenerating fibroid and was conservatively managed. 3 months later, the patient presented to our practice with persistent bleeding and a β-hCG of 19mIU/ml. Imaging revealed “aneurysmal expansion of lower uterine segment with extremely thin myometrium likely expanded Caesarean scar with dilated arteriovenous formation”. The patient underwent bilateral umbilical artery embolisation (UAE) and was followed closely. The bleeding ceased, and imaging showed resolution of the AVM by 6 weeks. This case supports the diagnosis of a uterine AVM after delayed diagnosis of a Caesarean scar pregnancy. In women with a prior Caesarean section, a Caesarean scar pregnancy must be ruled out prior to initial treatment of missed abortions. If a Caesarean scar pregnancy was initially diagnosed, methotrexate or a surgical wedge resection should have been offered. This may have prevented the formation of the AVM. Lastly, this case supports UAE as an option for patients desiring fertility-sparing treatments. Continued exploration of alternative treatment for women desiring future fertility and their success or postoperative complications is necessary." @default.
- W4387260287 created "2023-10-03" @default.
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- W4387260287 date "2023-10-01" @default.
- W4387260287 modified "2023-10-18" @default.
- W4387260287 title "EP28.01: Arteriovenous malformation in the setting of a possible Caesarean scar pregnancy managed surgically: a case report and literature review" @default.
- W4387260287 doi "https://doi.org/10.1002/uog.27166" @default.
- W4387260287 hasPublicationYear "2023" @default.
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