Clinical experience with postpartum treatment of a patient with arteriovenous malformation of uterine vessels
- Authors: Busygina L.A.1, Serova O.F.2, Garaeva L.R.1, Bakhtiyarov K.R.1, Isaev A.К.1, Barinova I.V.3, Abdullazhonov A.O.1
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Affiliations:
- Zhukovskaya City Clinical Hospital
- Moscow Regional Perinatal Center
- Moscow Regional Research Institute of Obstetrics and Gynecology
- Issue: Vol 10, No 4 (2023)
- Pages: 317-323
- Section: Clinical case reports
- URL: https://journal-vniispk.ru/2313-8726/article/view/219546
- DOI: https://doi.org/10.17816/2313-8726-2023-10-4-317-323
- ID: 219546
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Abstract
Uterine arteriovenous malformation is a rare vascular dysplasia where the uterine veins communicate with the branches of arteries of varying calibers. Patient K., a 37-years-old patient, presented with genital tract bleeding. Her medical history included operative labor at 37 weeks with dichorionic diamniotic twins, with the placental site on the posterior uterine wall exhibited firm attachment. The uterine cavity walls were scraped, and the bleeding vessel in the placental site was sutured. The blood loss amounted to 750 mL, and reinfusion was conducted. Fourteen days after giving birth, a heavy bloody discharge with blood clots from the genital tract occurred. The blood tests revealed no abnormalities. Echography detected multiple tubular structures that were anechoic on the posterior wall of the uterus, from the endometrium to the serosa, with the CDC mode blood flow. Magnetic resonance angiography revealed hypervascularization with premature arteriovenous discharge. Superselective embolization was performed on uterine artery afferents, and complete blood flow reduction was achieved, leading to the cessation of bleeding. On postoperative day 17, the patient experienced considerable bloody discharge from the genital tract, causing the hemoglobin level to decrease to 88 g/L. The presence of an arteriovenous malformation in the uterine vessels accompanied by ineffective embolization necessitated uterine extirpation. The postoperative phase was uneventful, and the patient was discharged from the hospital in satisfactory condition, with no evidence of anemia (hemoglobin, 115 g/L).
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##article.viewOnOriginalSite##About the authors
Liliya A. Busygina
Zhukovskaya City Clinical Hospital
Email: busyginala@mosreg.ru
ORCID iD: 0009-0003-8085-7863
Chief Medical Officer
Russian Federation, Zhukovsky, Moscow RegionOl’ga F. Serova
Moscow Regional Perinatal Center
Email: mopc02@mail.ru
ORCID iD: 0000-0002-4088-4619
MD, Dr. Sci. (Med.), Professor
Russian Federation, Balashikha, Moscow RegionLiliya R. Garaeva
Zhukovskaya City Clinical Hospital
Email: garaevlil@mail.ru
ORCID iD: 0009-0003-2318-1377
MD, Cand. Sci. (Med.)
Russian Federation, Zhukovsky, Moscow RegionKamil’ R. Bakhtiyarov
Zhukovskaya City Clinical Hospital
Email: doctorbah@mail.ru
ORCID iD: 0000-0002-3176-5589
MD, Dr. Sci. (Med.), Professor
Russian Federation, Zhukovsky, Moscow RegionAbdurahman К. Isaev
Zhukovskaya City Clinical Hospital
Author for correspondence.
Email: isaev.doc@mail.ru
ORCID iD: 0009-0000-9520-9357
MD, Dr. Sci. (Med.), Head of the Department
Russian Federation, Zhukovsky, Moscow RegionIrina V. Barinova
Moscow Regional Research Institute of Obstetrics and Gynecology
Email: mz_moniiag@mosreg.ru
ORCID iD: 0000-0003-0447-1734
MD, Dr. Sci. (Med.)
Russian Federation, MoscowAbror O. Abdullazhonov
Zhukovskaya City Clinical Hospital
Email: abror.abdullajono96@mail.ru
ORCID iD: 0009-0009-7612-8725
Doctor, Endovascular Surgeon
Russian Federation, Zhukovsky, Moscow RegionReferences
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