Ditchfield Emily J, Hill Suzanne, Saylany Lua, Samaratunga Ajith
Obstetrics and Gynaecology, Dubbo Hospital, Dubbo, AUS.
Faculty of Medicine and Health, University of Sydney, Sydney, AUS.
Cureus. 2025 Mar 31;17(3):e81497. doi: 10.7759/cureus.81497. eCollection 2025 Mar.
Uterine arteriovenous malformations (UAVMs) are rare, life-threatening conditions characterized by abnormal communications between uterine arteries and veins, often resulting in severe hemorrhage. This report discusses the case of a 32-year-old woman living in rural Australia, who experienced an acute life-threatening per vaginal bleed following uterine artery embolization (UAE) for an UAVM associated with a cesarean scar ectopic pregnancy. The patient's rural residence posed significant challenges, including delayed access to specialized care and prolonged travel distances. Despite UAE, she experienced a recurrence of hemorrhage and life-threatening blood loss and required emergency interventions, leading to a hysterectomy. This case highlights the lethality of UAVM, the risks of recurrence after UAE, and the importance of close post-procedural monitoring, particularly for patients in remote areas. It also emphasizes the need to incorporate social factors such as rurality into management decisions, advocating for systemic solutions to support high-risk patients.
子宫动静脉畸形（UAVM）较为罕见，是一种危及生命的病症，其特征为子宫动静脉之间存在异常交通，常导致严重出血。本报告讨论了一名居住在澳大利亚农村的32岁女性的病例，该患者因剖宫产瘢痕部位异位妊娠合并UAVM接受子宫动脉栓塞术（UAE）后，出现了危及生命的急性经阴道出血。患者居住在农村带来了诸多重大挑战，包括难以及时获得专科护理以及路途遥远。尽管进行了UAE，但她仍出现了出血复发和危及生命的失血情况，需要进行紧急干预，最终接受了子宫切除术。该病例凸显了UAVM的致死性、UAE后复发的风险以及术后密切监测的重要性，尤其是对于偏远地区的患者。它还强调了将诸如农村地区等社会因素纳入管理决策的必要性，倡导采取系统性解决方案来支持高危患者。
