Arteriovenous Malformation Complicating Cesarean Scar Pregnancy: A Rare case of Vaginal Bleeding Managed Successfully by Uterine Artery Embolization

Sangam Jha; Akanksha Singh

doi:10.18502/jfrh.v15i3.7140

Sangam Jha Department of Obstetrics and Gynecology, All India Institute of Medical Sciences Patna, Bihar, India
Akanksha Singh Department of Obstetrics and Gynecology, All India Institute of Medical Sciences Patna, Bihar, India

DOI: https://doi.org/10.18502/jfrh.v15i3.7140

Keywords: Cesarean Section; Arteriovenous Malformations; Uterine Artery Embolization

Abstract

Objective: Arteriovenous malformation (AVM) can occur in cesarean scar ectopic pregnancy. The presence of retained product of conception can pose a diagnostic dilemma and clinical presentation could be similar.

Case report: A 27 year old female presented with continuous vaginal bleeding for two and half months following dilatation and evacuation (D&E) done for cesarean scar pregnancy (CSP) of 10 weeks 4days period of gestation. Sonography with color Doppler revealed dilated tortuous vessels around the mass in lower uterine segment suggesting CSP with AVM. Digital subtraction angiography confirmed the diagnosis. Bilateral uterine artery embolization achieved complete devascularisation as confirmed on post intervention angiogram. Patient became symptom free since then.

Conclusion: Uterine artery embolization is an effective mode of treatment of AVM complicating CSP if future fertility is desired.