Dar Peer, Karmin Ira, Einstein Mark H
Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA.
Gynecol Obstet Invest. 2008;66(3):157-61. doi: 10.1159/000137687. Epub 2008 Jun 11.
BACKGROUND/AIM: Arteriovenous malformations (AVMs) of the uterus have various clinical presentations. With the advancement of and accessibility to imaging, the diagnosis of the lesions in association with less severe clinical presentations is becoming more common. Contrary to cases with severe hemorrhage, the management of these cases is not clear. The purpose of this study was to describe our experience with diagnosis, management and long-term follow-up of cases with different clinical presentations of uterine AVMs.
The clinical and sonographic presentations of 8 cases diagnosed between July 2000 and July 2003 in our medical center are described. Annual sonographic follow-up was performed for a period of at least 42 months.
Only 3 of the 8 cases presented with heavy vaginal bleeding and 2 of them required selective embolization. Two patients had hysterectomy during the study period which was not related to a severe bleeding event. Long-term follow-up for all other cases was significant for sonographic resolution of the uterine AVM.
Management of uterine AVMs should be influenced by the clinical and not by the sonographic findings. If clinically feasible, conservative management should be considered as the primary approach, since most of these lesions tend to spontaneously resolve.
背景/目的：子宫动静脉畸形（AVM）有多种临床表现。随着影像学技术的进步和可及性提高，与不太严重临床表现相关的病变诊断越来越常见。与严重出血的病例相反，这些病例的治疗尚不明确。本研究的目的是描述我们对不同临床表现的子宫AVM病例的诊断、治疗及长期随访经验。
描述了2000年7月至2003年7月在我们医疗中心诊断的8例病例的临床和超声表现。每年进行超声随访，为期至少42个月。
8例中仅3例出现大量阴道出血，其中2例需要选择性栓塞。研究期间有2例患者接受了子宫切除术，这与严重出血事件无关。所有其他病例的长期随访显示子宫AVM在超声检查下有明显消退。
子宫AVM的治疗应受临床情况而非超声检查结果的影响。如果临床可行，应考虑将保守治疗作为主要方法，因为这些病变大多倾向于自发消退。
