Severe Uterine Hemorrhage Resulting from Uterine Arteriovenous Malformation: A catastrophic scenario
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Abstract
Background: Abnormal uterine bleeding (AUB) is often challenging to diagnose in the emergency department (ED) due to its various causes. Uterine arteriovenous malformation (AVM) is a rare but significant gynaecological emergency that is frequently missed. It typically manifests as sudden and heavy vaginal bleeding, posing a potential life-threatening risk that requires immediate attention.
Case: A 40-year-old, para 3-0-0-3, woman presented to the ED with severe vaginal bleeding. Despite rapid resuscitation, she experienced hemodynamic instability. Uterine AVM was suspected based on colour Doppler pelvic ultrasound and later confirmed by angiography. Successful treatment was achieved with uterine artery embolization with complete resolution of the bleeding.
Conclusion: This case highlights the importance of early recognition and rapid resuscitation in treating uterine AVM with multidisciplinary team approach as a life-saving measure. Transcatheter arterial embolization is highly effective and preferred for preserving fertility in women. Timely intervention is crucial in managing this gynaecological emergency.
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