Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Apr:129:111103.
doi: 10.1016/j.ijscr.2025.111103. Epub 2025 Mar 1.

Arteriovenous malformations: A rare cause of postpartum hemorrhage. A case report

Khadija Errmili  1 , Youssef Essebbagh  2 , Aziz Slaoui  2 , Meryem Lamrani  2 , Najia Zeraidi  2 , Aziz Baidada  2
Affiliations
Case Reports

Arteriovenous malformations: A rare cause of postpartum hemorrhage. A case report

Khadija Errmili et al. Int J Surg Case Rep. 2025 Apr.

Abstract

Introduction: Uterine Acquired Arteriovenous Malformations are rare abnormalities that can cause postpartum hemorrhage, they are characterized by an abnormal connection between high-pressure arteries and low-pressure veins, which can result in symptoms ranging from pelvic pain to severe, life-threatening hemorrhages. Diagnosis and treatment can be performed via angiography.

Case report: A 32-year-old patient, with no significant medical history, underwent an uncomplicated cesarean section. Fifteen days postpartum, she was admitted to the emergency department for severe uterine hemorrhage, presenting with hemodynamic instability. Transvaginal ultrasound with Doppler revealed a uterine arteriovenous malformation. Due to her unstable condition, she underwent a hysterectomy following a blood transfusion.

Discussion: UAVMs can result from intrauterine trauma such as cesarean sections, abortions, or retained trophoblastic tissue. Symptoms include abnormal uterine bleeding, often associated with traumatic events. Diagnosis primarily relies on pelvic ultrasound with Doppler, which can suggest the presence of a UAVM. Angiography remains the gold standard, providing both diagnostic confirmation and therapeutic options, including embolization, which can be performed during the same procedure. The treatment of UAVMs depends on the clinical condition of the patient and her desire for future pregnancies. Embolization is the treatment of choice for stable patients, while hysterectomy is considered in cases of hemodynamic instability or bleeding resistant to embolization.

Conclusion: The diagnosis of UAVMs should be considered in cases of persistent abnormal uterine bleeding after delivery to determine appropriate treatment. Embolization is regarded as the gold standard treatment as long as the patient's hemodynamic condition allows it.

Keywords: Angiography; Embolization; Postpartum hemorrhage.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that they have no competing interests relevant to the content of this article.

Figures

Fig. 1
Fig. 1
Endovaginal ultrasound: Color Doppler imaging: vascular flows with both arterial and venous components.
Fig. 2
Fig. 2
Sagittal section of the hysterectomy piece.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Balayla J., Papillon Smith J. Uterine arteriovenous malformation. J. Obstet. Gynaecol. Can. Jun. 2021;43(6):683. doi: 10.1016/j.jogc.2019.10.011. - DOI - PubMed
    1. Sohrabi C., Mathew G., Maria N., Kerwan A., Franchi T., Agha R.A. The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines. Int J Surg Lond Engl. 2023;109(5):1136. - PMC - PubMed
    1. Campos C.I., Kujundzic W., Vergara-Galliadi L.M., Ávila F., Nieto-Calvache A.J. Diffuse uterine arteriovenous malformations as an unusual cause of secondary postpartum hemorrhage. J. Obstet. Gynaecol. Can. Mar. 2023;45(3):177–178. doi: 10.1016/j.jogc.2021.01.016. - DOI - PubMed
    1. Gao F., Ma X., Xu Y., Fu L., Guo X. Management of acquired uterine arteriovenous malformations associated with retained products of conception. J. Vasc. Interv. Radiol. May 2022;33(5):547–553. doi: 10.1016/j.jvir.2022.01.004. - DOI - PubMed
    1. Lamrissi A., Mabengui A.F., Mourabbih M., Jalal M., Fichtali K., Bouhya S. Acquired uterine arterio-venous malformation post molar pregnancy suction-curettage: 2 case reports. Int. J. Surg. Case Rep. May 2022;94 doi: 10.1016/j.ijscr.2022.107105. - DOI - PMC - PubMed

Publication types

LinkOut - more resources