ARTERIOVENOUS MALFORMATION OF THE UTERUS ASSOCIATED WITH A MISSED ABORTION

Arteriovenous malformation of the uterus is a rare uterine abnormality . This entity is generally associated with the presence of molar disea se, choriocarcinoma and uterine surgery, but may be congenitally acqui red. The presence of an arteriovenous malformation generally leads to unexplained profuse uterine bleeding. The diagnosis of this entity has traditionally been made by arteriography, and the treatment is usuall y hysterectomy. We present a patient with an arteriovenous malformatio n of the uterus whose prior delivery was by Cesarean section. The pati ent experienced episodes of heavy vaginal bleeding in the first month following the procedure of suction curettage for a first-trimester pre gnancy loss. Chorionic villus sampling performed prior to the procedur e showed a chromosomally normal fetus. The diagnosis of an arterioveno us malformation was made by color Doppler velocimetry and confirmed wi th arteriography. The patient desired to maintain her fertility. Inter ventional radiological techniques were successfully utilized to oblite rate the arteriovenous malformation with the use of polyvinyl alcohol particles (250 mum) and gelfoam. Discussion includes the presenting si gns and symptoms along with the method of both diagnosis and conservat ive management.