MULTIPLE AND MASSIVE ARTERIOVENOUS-MALFORMATIONS IN PREGNANCY

Arteriovenous malformations (AVM) are rare in the reproductive years o f life. There is a paucity of data regarding AVMs in pregnancy. Pregna ncy can influence both the development and the progression of AVMs. Th e tendency to bleed is unpredictable. Many AVMs undergo spontaneous po stpartum regression. We report on a 30-year old primipara with multipl e generalised AVMs. both congenital and acquired, and a massive congen ital AVM involving her entire right upper limb and shoulder girdle. Ma gnetic resonance imaging suggested there were AVMs in both the pelvis and the lower abdominal wall. The main management dilemma was mode of delivery. A trial of vaginal delivery was successful after spontaneous onset at term. The patient had a series of significant postpartum hae morrhages, warranting blood transfusion.