Sánchez-Usabiaga RA, González-Becerra JE, Romero-Tovar S, Hurtado-Amador R, Batista-Espinoza A

Language: Spanish
References: 0
Page: 27-31
PDF size: 371.22 Kb.

ABSTRACT

Objetive: We report a case of a patient with arteriovenous fistula secondary to an instrumented uterine curettage, related to presence of placental polyps.
Clinical case: A 29-year-old woman, who went to a doctor’s office for a pregnancy protocol, reached spontaneously, but its finalized in abortion for an anembrionrary pregnancy of 8 weeks. The Doctor performed instrumented uterine curettage. Five months after the event, the patient had abnormal (abundant) uterine bleeding, which required hospitalization. Ultrasound with increased vascularization in the posterior wall, with suspected venereal arteries, normal Doppler velocimetry, and low diastole with low resistance. The physician suggested selective arterial embolization. A comprehensive evaluation of the pathology was performed by ultrasound, in which an intracavitary mass was observed with mixed echoes, suggestions of retention of ovuloplacental remains, later verified with hysteroscopy. During the hysteroscopic procedure (with Hopkins II, Karl Storz of 2 mm and a 2.8 mm “diagnostic” shirt), a mass compatible with the ovuloplacental remains attached to the posterior aspect of the uterus was detected. After the integral evaluation, it was decided to perform the uterine evacuation, using hysteroscopy, with a resectoscope without energy. The histopathological study reported ovuloplacental remains with marked changes by retention, necrotic and hemorrhagic decidua, with severe subacute inflammation. The patient progressed satisfactorily during the postoperative period. The ultrasonographic evaluation of control did not show the arteriovenous fistula.