A postpartum arteriovenous malformation case diagnosed with late postpartum bleeding

Abstract

Postpartum hemorrhage is the most important and also preventable cause of maternal morbidity and mortality worldwide. Arteriovenous malformation (AVM) is a rare cause of postpartum hemorrhage. We present a case of arteriovenous malformation, which may be one of the rare but potentially fatal causes of postpartum hemorrhage (PPH). In the case report, on the postpartum 52^nd day, the patient presented to the emergency department with a complaint of vaginal bleeding. Doppler ultrasonography revealed a lesion compatible with the vascular structure, the largest diameter of 28 * 28 mm, in the uterus. The patient was found not eligible for embolization, and a hysterectomy was then indicated. After the hysterectomy, the pathology diagnosis supported the initial clinical and radiological suspicions of AVM. Hysterectomy is the definitive treatment method of AVM and should be considered in patients who are not eligible for embolization. This case is presented to draw the attention of physicians to AVM as a possible cause of secondary PPH.

Keywords: Arteriovenous malformations; Doppler ultrasonography; hysterectomy; postpartum hemorrhage; uterine artery embolization.