[Diagnosis and management of uterine arteriovenous fistula with massive vaginal bleeding]

Abstract

Objective: To study the clinical manifestation, diagnosis, management and prognosis of uterine arteriovenous fistula with massive vaginal bleeding.

Method: The clinical records of 15 patients who satisfied the diagnostic criteria were retrospectively analyzed.

Results: All patients had massive vaginal bleeding, with a history of caesarean section, curettage or gynecologic carcinoma. The disease could be diagnosed by angiography or color Doppler ultrasound. Vaginal bleeding was aggravated by dilation and curettage. Fourteen patients were treated with uterine artery embolization, and no complications occurred postembolization. Of the eleven successful embolizations, all patients returned normal menstrual cycling. Five of these patients became pregnant later.

Conclusions: Uterine arteriovenous fistula is a rare and potentially life threatening disease. Uterine artery embolization is a safe and effective treatment for this disease, and it can preserve normal function of uterus and ovaries.