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宫腔镜检查确诊子宫动静脉畸形为复发性流产的可能病因

Hysteroscopic Confirmation of a Uterine Arteriovenous Malformation as a Possible Cause of Recurrent Pregnancy Loss.

作者信息

Reyftmann Lionel, Kothari Dharmesh, Power Mark

机构信息

Genea, Wollongong Day Surgery, Wollongong, New South Wales, Australia.

Graduate Medicine, University of Wollongong, Wollongong, New South Wales, Australia.

出版信息

Case Rep Obstet Gynecol. 2025 Jul 25;2025:6655067. doi: 10.1155/crog/6655067. eCollection 2025.

Abstract

This case report highlights the cornerstone role played by hysteroscopy to confirm a diagnosis of uterine arteriovenous malformations that was ambiguous with the imaging studies. A 30-year-old nulliparous woman who experienced three unexplained recurrent pregnancy losses was suspected of having a uterine arteriovenous malformation. The arteriovenous malformation was confirmed through hysteroscopy and managed with a multidisciplinary approach involving interventional radiology and reproductive specialists. The hysteroscopy was followed by uterine artery embolization, which resulted in the resolution of the arteriovenous malformation. A spontaneous pregnancy and live birth rapidly followed. Uterine arteriovenous malformations have been widely reported in gynecology as a consequence of the surgical treatment of a miscarriage or gestational trophoblastic disease. We suggest that they are also important to diagnose in patients presenting with recurrent pregnancy loss, where they represent a curable etiology.

摘要

本病例报告强调了宫腔镜检查在确诊子宫动静脉畸形中所起的基石作用,而影像学检查对此诊断并不明确。一名30岁未生育女性经历了三次不明原因的反复妊娠丢失,怀疑患有子宫动静脉畸形。通过宫腔镜检查确诊了动静脉畸形,并采用了介入放射学和生殖专家参与的多学科方法进行治疗。宫腔镜检查后进行了子宫动脉栓塞,动静脉畸形得以消退。随后很快自然受孕并活产。子宫动静脉畸形在妇科中因流产或妊娠滋养细胞疾病的手术治疗而被广泛报道。我们认为,对于反复妊娠丢失的患者,诊断子宫动静脉畸形也很重要,因为这是一种可治愈的病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2141/12316497/ed8d366abfad/CRIOG2025-6655067.001.jpg

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