P18.02: Case report: abnormal uterine bleeding, uterine arteriovenous malformation and uterine angioma—diagnosis and management

Abstract

Abnormal uterine bleeding secondary to uterine arteriovenous malformation. This is a case of a nulliparous young woman (SCS 20 years old) who comes to emergency service because a profuse acute vaginal bleeding. She has no history of previos pregnancy, no use of hormonal contraceptives or uterine devices. No history of previus uterine surgery. Findings: severe anemia (Hb 6.5 g) hemodynamic compromise. Accurate diagnosis of uterine arteriovenous malformation by ultrasound and intravascular treatment (embolisation of bilateral uterine arteries with PVA microparticles of 1000 micras) was the best way to stops vaginal bleeding. Hemodynamic stabilization was easy and no need blood transfusion. Iron sucrose injection was used for the anemia. We have two years of follow up with a normal menstrual periods and healthy asymptomatic life in this case. We show the images by Ultrasound Color Doppler and Tridimensional US. Angyography and embolization in pictures.