An unsuspected case of uterine arteriovenous malformation with nidus aneurysm following vaginal delivery: Diagnostic challenges and management

阴道分娩后意外发现子宫动静脉畸形伴血管瘤:诊断挑战与治疗

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Abstract

Uterine arteriovenous malformations (AVMs) are rare but potentially life-threatening cause of postpartum hemorrhage (PPH). Accurate differentiation from other PPH causes, such as retained products of conception (RPOC) and gestational trophoblastic disease (GTD), is imperative, as inadvertent improper management such as uterine curettage may cause catastrophic bleeding with high mortality rates. We present the case of 35-year-old woman who presented with excessive vaginal bleeding 2 months postnormal vaginal delivery. Initial ultrasound findings raised suspicion of uterine AVM with a differential diagnosis of type 3 RPOC. Further imaging with computed tomography angiography (CTA) and digital subtraction angiography (DSA) confirmed an underlying uterine AVM with a nidus aneurysm. The patient subsequently was treated with successful embolization and was discharged in stable condition.

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