Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Department of Obstetrics and Gynecology and Women's Health, Taichung Veterans General Hospital, Taichung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biomedical Sciences, Program in Translational Medicine, and Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan, ROC.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):703-707. doi: 10.1016/j.tjog.2021.06.001.
Symptomatic Uterine arteriovenous malformation (AVM) can result in sudden and massive vaginal bleeding that can be life-threatening. We report a new fertility-preserving treatment modality for disastrous bleeding caused by acquired uterine AVM: Combination laparoscopic ligation of uterine arteries and AVM suture.
A 39-year-old female received Dilatation and Curettage due to missed abortion. However, she experienced heavy vaginal bleeding after surgery. Uterine arteriovenous malformation (AVM) was diagnosed by color Doppler ultrasonography, hysteroscopy, and angiography. She was successfully treated using laparoscopy bilateral uterine arteries ligation followed by application of uterine AVM suture with absorbable barbed wound closure device. After the laparoscopic surgery, vaginal bleeding stopped immediately. Complete regression of the AVM lesion on sonography was noted 8 months after laparoscopic surgery. Besides, this patient had normal menstruation after the operation.
This case report describes for the first time a successful combination of bilateral uterine artery ligation and AVM suture to treat a patient with uterine arteriovenous malformation. We demonstrated the efficacy and safety of this fertility preserving method.
症状性子宫动静脉畸形（AVM）可导致突然大量阴道出血，危及生命。我们报告了一种新的治疗方法，用于保留生育能力的灾难性出血的获得性子宫 AVM：腹腔镜下子宫动脉结扎联合 AVM 缝合。
一名 39 岁女性因稽留流产而行刮宫术，但术后出现大量阴道出血。彩色多普勒超声、宫腔镜和血管造影诊断为子宫动静脉畸形（AVM）。她接受了腹腔镜双侧子宫动脉结扎术，随后使用可吸收带刺缝合线闭合装置进行子宫 AVM 缝合，成功治疗。腹腔镜手术后，阴道出血立即停止。腹腔镜手术后 8 个月，超声检查显示 AVM 病变完全消退。此外，该患者术后月经正常。
本病例报告首次描述了一种成功的双侧子宫动脉结扎术联合 AVM 缝合术治疗子宫动静脉畸形的方法。我们证明了这种保留生育能力方法的有效性和安全性。
