Sahoo Biswajit, Jena Saubhagya K, Mishra Sourav K, Mitra Subarna, Pitchaimuthu Arunprakash, Nayak Manoj
Radiology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Cureus. 2024 Jul 10;16(7):e64209. doi: 10.7759/cureus.64209. eCollection 2024 Jul.
Uterine arteriovenous malformations (AVM) are rare and usually present in women of reproductive age. Clinical presentation may overlap with early pregnancy, retained products of conception (RPOC), or gestational trophoblastic disease (GTD) if it occurs in a pregnant patient or the immediate postpartum period and becomes challenging to manage. Here, we present two cases of uterine AVM that presented with vaginal bleeding after miscarriages. In these cases, the presentation was vaginal bleeding with raised serum beta-human chorionic gonadotropin (β-hCG) levels. The uterine AVM was diagnosed with ultrasound and contrast-enhanced CT and subsequently managed with uterine artery embolization. Although rare, uterine AVM should be kept in the differentials in a premenopausal patient with abnormal vaginal bleeding and positive serum β-hCG levels. It should be differentiated from other common causes of vaginal bleeding with raised serum β-hCG levels, such as early pregnancy, GTD, and RPOC, as early diagnosis and proper treatment are crucial for favorable outcomes.
子宫动静脉畸形（AVM）较为罕见，通常见于育龄女性。如果发生在孕妇或产后即刻，其临床表现可能与早期妊娠、稽留流产（RPOC）或妊娠滋养细胞疾病（GTD）重叠，从而给治疗带来挑战。在此，我们报告两例子宫AVM患者，她们在流产后出现阴道出血。在这些病例中，表现为阴道出血且血清β-人绒毛膜促性腺激素（β-hCG）水平升高。子宫AVM通过超声和增强CT得以诊断，随后接受了子宫动脉栓塞治疗。尽管罕见，但对于绝经前出现异常阴道出血且血清β-hCG水平阳性的患者，子宫AVM应列入鉴别诊断范围。应将其与血清β-hCG水平升高的其他常见阴道出血原因，如早期妊娠、GTD和RPOC相鉴别，因为早期诊断和恰当治疗对于取得良好预后至关重要。
