PDF(Pubmed)
Abstract：
Uterine arteriovenous malformation (AVM) is a rare but serious condition that can cause heavy uterine bleeding. It occurs when abnormal connections form between the arteries and veins in the uterus, leading to significant health complications. Accurate identification and diagnosis are crucial because overlooking or mishandling them can lead to severe, life-threatening bleeding. We present the case of a 30-year-old patient presenting with abnormal uterine bleeding 15 days after she gave birth to her second child. The ultrasound examination showed images suggestive of retained ovuloplacental remnants, so a uterine aspiration was performed, but the patient presented severe vaginal bleeding. Subsequently, magnetic resonance imaging (MRI) was performed, demonstrating the presence of a prominent lesion in the posterior wall of the uterine body with multiple serpentine-like pathways and a signal void suggestive of aberrant vessels corresponding to AVMs. Ergotrate and misoprostol were administered to control the bleeding, and a Bakri balloon was inserted and maintained until the bleeding stopped. We are highlighting this case to emphasize the importance of considering uterine AVM (UAVM) when dealing with abnormal uterine bleeding, even in the postpartum period. Due to its rarity, there is a lack of substantial evidence to guide clinicians in managing this condition.
摘要：
子宫动静脉畸形（AVM）是一种罕见但严重的疾病，可导致大量子宫出血。它发生在子宫动脉和静脉之间形成异常连接时，导致严重的健康并发症。准确的识别和诊断至关重要，因为忽视或处理不当会导致严重的，危及生命的出血.我们介绍了一名30岁的患者在生下第二个孩子15天后出现异常子宫出血的情况。超声检查显示图像提示保留的卵巢胎盘残留物，所以做了子宫抽吸术,但患者出现严重的阴道出血.随后，磁共振成像（MRI），显示在子宫体后壁存在明显的病变，具有多个蛇纹石样途径和信号空洞，提示对应于AVM的异常血管。Ergotrate和米索前列醇用于控制出血，插入Bakri气球并保持直到出血停止。我们强调这种情况是为了强调在处理异常子宫出血时考虑子宫AVM（UAVM）的重要性，即使在产后。由于它的稀有性,目前缺乏大量证据来指导临床医生治疗这种疾病.
