Case Report

Acquired uterine arteriovenous malformation after cesarean section

Muhammad Al Farisi Sutrisno, Fatimah Usman, Rizani Amran, Iskandar Zulqarnain, Heriyadi Manan, KY Effendi, Adnan Abadi
Department of Obstetrics and Gynaecology, Faculty of Medicine, Sriwijaya University, M. Hoesin Hospital Palembang, Indonesia

HIGHLIGHTS

1. Acquired uterine arteriovenous malformation (AVM) is an uncommon sequela of cesarean section, warranting consideration in instances of persistent uterine bleeding in the puerperium.
2. Embolization represents a viable and well-established treatment modality for AVM, providing a safe and efficacious intervention that serves as an alternative, less invasive modality for patients desiring fertility preservation.

ABSTRACT

Objectives: To demonstrate that embolization is a viable and well-established treatment for acquired arteriovenous malformations (AVMs), offering a safe and effective, less invasive option for patients seeking to preserve fertility.
Case Report: A 20-year-old female experiencing recurrent massive bleeding with a history of previous caesarean section and wound infection resuturing. The transvaginal color Doppler ultrasound showed a hypervascularity in the uterus around the surgical lesion, suggesting a uterine AVM and its confirmed by angiography. The patient underwent a series of uterine artery embolization interventions, which proved to be a successful therapeutic approach. As a result of this treatment modality, not only was the patient's condition effectively resolved, but her fertility was also preserved.
Conclusion: Acquired uterine arteriovenous malformation (AVM) is an uncommon sequela of cesarean section, warranting consideration in instances of persistent uterine bleeding in the puerperium. Embolization represents a viable and well-established treatment modality for AVM, providing a safe and efficacious intervention that serves as an alternative, less invasive modality for patients desiring fertility preservation.

Keywords: arteriovenous malformation (AVM); postpartum hemorrhage; ultrasonography; CT angiography; uterine artery embolization; maternal health