Uterine arteriovenous malformation

Arteriovenous fistulas or uterine arteriovenous malformation constitute a very rare and potentially serious pathology due to the abnormal bleeding that originates in the anomalous communications between arteries and veins

They may be congenital or acquired, we think that the AV fistula term should be reserved for acquired cases and the AV malformation term for the congenital form. Congenital cases are rare, being the consequence of a defect of embryological development, and usually affect adjacent organs and structures. Classically, acquired fistulas have been correlated to chorio-placental pathology such as molar pregnancy, choriocarcinoma or extensive or focal placental accreta and previous uterine surgery. In cases in which this entity is associated with previous uterine surgery, the vast majority of are related to previous uterine curettage and is assumed to form as a result of trauma.

The diagnosis is usually made by the symptoms and ultrasound, with arteriography being the gold standard for the definitive diagnosis of AV fistulas. Clinical symptoms are usually associated with persistent vaginal bleeding after curettage with or without abdominal pain. This abnormal bleeding can present from days to years after the curettage.

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