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Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases.

Chen LK, Yang BL, Chen KC, Tsai YL - Iran J Radiol (2016)

Bottom Line: We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography.The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA).Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan.

ABSTRACT
Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

No MeSH data available.


Related in: MedlinePlus

A 22-year-old female with prolonged menstrual bleeding for 2 weeks and sudden heavy vaginal bleeding. A, Gray-scale ultrasonography reveals multiple hypo-echoic myometrial lesions. B, Color Doppler ultrasonography shows a hypervascular lesion, 3.0 × 2.7 × 1.7 cm in the endometrium and myometrium of the uterine fundus. C and D, Angiography of the right and left uterine arteries demonstrates multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting. E and F, After treatment, angiography shows total occlusion of AVM.
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fig23435: A 22-year-old female with prolonged menstrual bleeding for 2 weeks and sudden heavy vaginal bleeding. A, Gray-scale ultrasonography reveals multiple hypo-echoic myometrial lesions. B, Color Doppler ultrasonography shows a hypervascular lesion, 3.0 × 2.7 × 1.7 cm in the endometrium and myometrium of the uterine fundus. C and D, Angiography of the right and left uterine arteries demonstrates multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting. E and F, After treatment, angiography shows total occlusion of AVM.

Mentions: A 22-year-old female, G2P0, spontaneous abortion 1, artificial abortion 1, with regular menstrual cycles in the past had threatened abortion 2 months before she came to outpatient department due to prolonged menstrual flow for 2 weeks with sudden heavy vaginal bleeding. She also noted dizziness and fatigue for days without dyspnea. Her temperature was 36.1°C, heart rate was 76 times/minute, respiratory rate was 18 times/minute, and blood pressure was 116/70 mmHg. The beta-HCG and CA-125 were in the normal range. Gray-scale ultrasonography revealed multiple hypo-echoic myometrial lesions (Figure 3A). Color and spectral Doppler ultrasonography showed a hypervascular lesion, 3.0 × 2.7 × 1.7 cm with multidirectional turbulent flow (Figure 3B), and RI was 0.3. Angiography showed multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting (Figure 3C and D). TAE was performed using NBCA to obstruct the bilateral uterine arteries (Figure 3E and F). After TAE, she complained of severe lower abdominal pain, which was refractory to demerol. Patient controlled analgesia was used and the pain subsided. She was discharged 3 days after treatment. She had menstruation at 65 days after TAE. Three years later, she was admitted to our hospital for normal spontaneous delivery with a gestational age of 39 weeks. The baby girl was healthy, Apgar scores were 9/9, and body weight was 3020 gm. The placenta was delivered by complicated manual removal with both surface (Duncan and Schultze), but there was no gross abnormal finding, including cord abnormalities. Her prenatal examination was uneventful, and there were no complications during delivery or the postpartum period.


Successful Transarterial Embolization of Uterine Arteriovenous Malformation: Report of Three Cases.

Chen LK, Yang BL, Chen KC, Tsai YL - Iran J Radiol (2016)

A 22-year-old female with prolonged menstrual bleeding for 2 weeks and sudden heavy vaginal bleeding. A, Gray-scale ultrasonography reveals multiple hypo-echoic myometrial lesions. B, Color Doppler ultrasonography shows a hypervascular lesion, 3.0 × 2.7 × 1.7 cm in the endometrium and myometrium of the uterine fundus. C and D, Angiography of the right and left uterine arteries demonstrates multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting. E and F, After treatment, angiography shows total occlusion of AVM.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835739&req=5

fig23435: A 22-year-old female with prolonged menstrual bleeding for 2 weeks and sudden heavy vaginal bleeding. A, Gray-scale ultrasonography reveals multiple hypo-echoic myometrial lesions. B, Color Doppler ultrasonography shows a hypervascular lesion, 3.0 × 2.7 × 1.7 cm in the endometrium and myometrium of the uterine fundus. C and D, Angiography of the right and left uterine arteries demonstrates multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting. E and F, After treatment, angiography shows total occlusion of AVM.
Mentions: A 22-year-old female, G2P0, spontaneous abortion 1, artificial abortion 1, with regular menstrual cycles in the past had threatened abortion 2 months before she came to outpatient department due to prolonged menstrual flow for 2 weeks with sudden heavy vaginal bleeding. She also noted dizziness and fatigue for days without dyspnea. Her temperature was 36.1°C, heart rate was 76 times/minute, respiratory rate was 18 times/minute, and blood pressure was 116/70 mmHg. The beta-HCG and CA-125 were in the normal range. Gray-scale ultrasonography revealed multiple hypo-echoic myometrial lesions (Figure 3A). Color and spectral Doppler ultrasonography showed a hypervascular lesion, 3.0 × 2.7 × 1.7 cm with multidirectional turbulent flow (Figure 3B), and RI was 0.3. Angiography showed multiple abnormal vessels from the bilateral uterine arteries, particularly from the right side, and rapid venous shunting (Figure 3C and D). TAE was performed using NBCA to obstruct the bilateral uterine arteries (Figure 3E and F). After TAE, she complained of severe lower abdominal pain, which was refractory to demerol. Patient controlled analgesia was used and the pain subsided. She was discharged 3 days after treatment. She had menstruation at 65 days after TAE. Three years later, she was admitted to our hospital for normal spontaneous delivery with a gestational age of 39 weeks. The baby girl was healthy, Apgar scores were 9/9, and body weight was 3020 gm. The placenta was delivered by complicated manual removal with both surface (Duncan and Schultze), but there was no gross abnormal finding, including cord abnormalities. Her prenatal examination was uneventful, and there were no complications during delivery or the postpartum period.

Bottom Line: We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography.The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA).Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

View Article: PubMed Central - PubMed

Affiliation: Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, National Taiwan University, Taipei, Taiwan.

ABSTRACT
Uterine arteriovenous malformations (AVMs) are relatively rare disorders that can cause life-threatening vaginal bleeding. We describe three childbearing-age females, who had abdominal pain and heavy vaginal bleeding, and were diagnosed as uterine AVM by color Doppler and angiography. The patients received successful superselective transarterial embolization (TAE) with N-butyl cyanoacrylate (NBCA). Three years after treatment, one of them was admitted to our hospital for vaginal delivery at 39 weeks of gestation, and the baby was healthy.

No MeSH data available.


Related in: MedlinePlus