Presenting features of women with uterine arteriovenous malformations

Objective: To describe the outcome of patients with uterine arteriovenous malformations (AVMs) after uterine artery embolization (UAE). Design: Retrospective case series. Setting: Tertiary center of a university hospital. Patient(s): Thirteen patients were referred to a tertiary medical center from primary care facilities with profuse uterine bleeding. Intervention(s): Uterine artery embolization. Main Outcome Measure(s): Thirteen patients underwent UAE. Eleven patients had no additional vaginal bleeding, whereas two patients underwent hysterectomy after embolization. Result(s): Twelve patients developed AVMs after induced abortions. One patient had a congenital uterine AVM. Based on the transfer notes, eight cases had incomplete abortions, three cases had dysfunctional uterine bleeding, one case had a molar pregnancy, and one case had a uterine AVM. Two cases underwent hysterectomy after UAE. One patient delivered a healthy baby after bilateral UAE. Conclusion(s): Uterine AVMs should be suspected in patients with abrupt, profuse vaginal bleeding and a medical history of an induced abortion. Primary physicians should consider uterine AVMs with such a medical history. A prompt diagnosis and therapy are essential for favorable outcomes in patients with uterine AVMs. (Fertil Steril (R) 2010; 94: 2330. e7e10. (C) 2010 by American Society for Reproductive Medicine.)