Mekaru Keiko, Oishi Sugiko, Akamine Kozue, Heshiki Chiaki, Aoki Yoichi
Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
Case Rep Obstet Gynecol. 2017;2017:6437670. doi: 10.1155/2017/6437670. Epub 2017 Feb 16.
Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16-22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment.
子宫动静脉畸形(AVM)可导致大量出血,常采用子宫动脉栓塞术(UAE)治疗,这可能会导致卵巢功能不全。因此,应考虑避免进行UAE,尤其是对于正在接受生育治疗的女性。我们报告了三名经阴道超声成像彩色多普勒诊断为流产后AVM的女性。她们没有生殖器出血,有一个小肿块,大小为16 - 22毫米。如果在诊断AVM时雌二醇>300 pg/mL,则给予促性腺激素释放激素激动剂。所有三名女性均接受了随访观察,结果显示肿块自发消失。为避免UAE带来的卵巢功能不全风险,对于无出血的AVM患者,尤其是在生育治疗期间,应考虑保守治疗和密切随访观察。