PDF(Pubmed)
Abstract：
Uterine arteriovenous malformations (AVM) are rare and usually present in women of reproductive age. Clinical presentation may overlap with early pregnancy, retained products of conception (RPOC), or gestational trophoblastic disease (GTD) if it occurs in a pregnant patient or the immediate postpartum period and becomes challenging to manage. Here, we present two cases of uterine AVM that presented with vaginal bleeding after miscarriages. In these cases, the presentation was vaginal bleeding with raised serum beta-human chorionic gonadotropin (β-hCG) levels. The uterine AVM was diagnosed with ultrasound and contrast-enhanced CT and subsequently managed with uterine artery embolization. Although rare, uterine AVM should be kept in the differentials in a premenopausal patient with abnormal vaginal bleeding and positive serum β-hCG levels. It should be differentiated from other common causes of vaginal bleeding with raised serum β-hCG levels, such as early pregnancy, GTD, and RPOC, as early diagnosis and proper treatment are crucial for favorable outcomes.
摘要：
子宫动静脉畸形（AVM）很少见，通常存在于育龄妇女中。临床表现可能与妊娠早期重叠，保留的受孕产物(RPOC)，或妊娠滋养细胞疾病（GTD），如果它发生在怀孕的患者或产后期，并且变得具有挑战性的管理。这里,我们介绍了2例流产后出现阴道出血的子宫AVM。在这些情况下,表现为阴道出血,血清β-人绒毛膜促性腺激素(β-hCG)水平升高.超声和对比增强CT诊断子宫AVM，随后进行子宫动脉栓塞治疗。虽然罕见，在阴道出血异常且血清β-hCG水平阳性的绝经前患者中，应将子宫AVM保持在差异中。应将其与其他常见的阴道出血原因与血清β-hCG水平升高区分开来。比如怀孕初期,GTD,和RPOC,因为早期诊断和适当的治疗对于有利的结果至关重要。
