2017, Number 02
Ginecol Obstet Mex 2017; 85 (02)
Rosas-Delgadillo N, Padilla-Rodríguez AL
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ABSTRACTBackground: Arteriovenous malformation is a high flux and low resistance vascular system defect that consists of a blending of arteries and veins without interposition of a capillary system, in response of an increasing anomalous angiogenesis. Uterine arteriovenous malformation is a rare entity, with only 300 cases reported, being even more uncommon as a cause of postpartum bleeding, with only thirteen cases in the literature. We report the fourteenth case of uterine arteriovenous malformation associated with postpartum bleeding.
Case Report: It was a 40- year-old female in her third pregnancy, who presented with two episodes of intermittent, profuse vaginal bleeding at 23th and 28th days posterior to the cesarean delivery. She was submitted to hysterectomy after medical treatment without remission. Macroscopically the uterus showed multiple dilated spaces in the whole thickness of the myometrium that histologically corresponds to multiple medium to large thickened wall vessels, without intervening of capillaries throughout uterine myometrial surface.
Conclusions: Postpartum bleeding is a well-known complication during puerperium that increases the maternal mortality rates. Uterine arteriovenous malformation despite of its relative low frequency must be taken account as a cause of puerperal bleeding. It is recommended to intentionally search ultrasonographic early signs of vascular malformations in uterus during the prenatal control.