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DOI: 10.1055/s-0043-1763304
The Impact of Postuterine Artery Embolization for Uterine Arteriovenous Malformation on Fertility
Introduction: Uterine arteriovenous malformation (AVM) is very rare but it is a life-threatening condition. Clinical presentation varies from no symptom to menorrhagia up to massive life-threatening vaginal bleeding. The pathogenesis of infertility after bilateral UAE is not yet known so we report our experience.
Method(s): A total of 10 patients with high flow uterine AVM after treated ectopic pregnancy. Through single femoral puncture access uterine artery angiogram confirmed presence of AVM in the uterine wall with draining vein, so bilateral UAE was done in two successive sessions with 1 week interval first done by Histoacryl with lipidol then by coils in the second session. Embolization proceeded until a standing column of contrast in the uterine artery observed. Follow-up by transvaginal color Doppler ultrasound for 6 months.
Result(s): Cessation of bleeding in all 10 patients with no recurrence and marked reduction of the size and the flow of the AVM during the follow-up. Seven patients delivered live births but 3 women required a subsequent hysterectomy and lose their fertility chance. All 7 patients followed until their deliveries.
Conclusion(s): Bilateral UAE is a safe and effective technique for management of uterine AVM and should be considered as an initial therapy in symptomatic women with AVM at reproductive age desiring future fertility.
Publication History
Article published online:
09 February 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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