Uterine Arteriovenous malformation: A Review of current literatures.

Abstract

Introduction

Arteriovenous malformations (AVMs) are vascular channels composed of admixture of arteries and veins without intervening capillaries. These AVMs consist of numerous fragile low-resistant arteriovenous shunts. AVM can occur in any part of the body such as the brain, spleen, lung, kidney, liver, intercostals spaces, iris and spermatic cord.¹ In general, AVMs are most commonly congenital and genetic transmission patterns are unknown.¹ The uterus is involved less commonly by AVM. Uterine arteriovenous malformation (UAVM) is a rare condition that affects women of reproductive age and clinically presents with unexplained profuse bleeding par vagina. The bleeding is usually intermittent, torrential, or may be intractable and life threatening. UAVM are abnormal vascular channels that involve the myometrium and occasionally the endometrium. Myometrial involvement is more common than endometrial AVMs. Endometrial affectation is usually from extension of the myometrial UAVM. The first case of uterine AVM was reported by Dubreuil and Loubat in 1926.²

Vaginal bleeding in women of reproductive age is usually pregnancy related for which UAVM is a cause that health personnel involved in the care of such cases should be familiar with. The bleeding from UAVM may occur as a result of exposure of the AVM from sloughed endometrium during menstruations or from uterine instrumentations. The bleeding can be severe enough to warrant multiple pints of blood transfusions as well as more drastic management to preserve the life of the patient. Uterine AVM is also a cause of recurrent pregnancy loss. Recurrent pregnancy loss can have a devastating effect on these women, her family and close relatives.