Resolution of Post-Molar Pregnancy Uterine Arteriovenous Malformation Following Treatment with GnRH Agonist Concomitantly with an Aromatase Inhibitor and Tranexamic Acid

2020 ◽  
pp. 1-3
Author(s):  
Angelos G. Vilos ◽  
Olga Haakman ◽  
Tina Liang ◽  
Nabigah Alzawawi ◽  
Jennifer Lam ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Arteriovenous Malformation ◽  
Aromatase Inhibitor ◽  
Gnrh Agonist ◽  
Medical Management ◽  
Severe Bleeding ◽  
Molar Pregnancy ◽  
Case Presentation ◽  
Suction Curettage ◽  
Uterine Arteriovenous Malformation

Background: Acquired uterine arteriovenous malformations (AVM) are a rare but potentially serious condition that can result in severe bleeding. Rarely, uterine AVM can occur following a complete molar pregnancy. Resolution of AVMs has been reported recently with conservative management using a combination of Gonadotropin-Releasing Hormone (GnRH) agonist, an aromatase inhibitor and tranexamic acid. This treatment has not previously been reported in a patient with AVM post molar gestation. Case Presentation: A 23-year-old woman was diagnosed with a large uterine arteriovenous malformation following a suction curettage for a molar pregnancy. Complete resolution of the lesion on imaging was seen after six weeks of medical management. Conclusion: A uterine arteriovenous malformation can develop in a patient post complete molar pregnancy and can be successfully treated with medical management.

scholarly journals Successful medical management of uterine arteriovenous malformation

2021 ◽  
Vol 10 (6) ◽  
pp. 2519
Author(s):  
Aparajita Rastogi ◽  
Neetu Kumari ◽  
Sarita Rajbhar ◽  
Pushpawati Thakur ◽  
Sagarika Majumdar
Keyword(s):  
Side Effects ◽  
Arteriovenous Malformation ◽  
Gnrh Agonist ◽  
Medical Management ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Reproductive Age ◽  
Artery Embolization ◽  
Future Fertility ◽  
Uterine Arteriovenous Malformation

Uterine Arteriovenous malformation (AVM) is defined as abnormal communication between the uterine arteries and veins. This can be congenital or acquired. It occurs more frequently in reproductive age group women. Patient present with complain of spotting per vagina to catastrophic bleeding per vaginum. Diagnosis is based upon clinical history and findings in colour doppler of pelvis. The treatment depends upon the age of the patient, her symptoms, age, desire of future fertility and localization and size of the lesion. Uterine artery embolization is the most commonly used treatment for symptomatic uterine arteriovenous malformation. There were few case reports of successful medical management of uterine AVM with GnRH agonist. But GnRH agonist have side effects that restrict its long time use and for Uterine artery embolization, clinical skill and set up is required and it is not available at every hospital. Here is presenting a case report of successful medical management of uterine arteriovenous malformation with combined oral contraceptive pills (coc). COC are easily available everywhere and its side effects are few if compared with GnRH agonist.

scholarly journals A Misdiagnosed Molar Pregnancy Ended Up in Excessive Haemorrhage Which was Later Diagnosed as a Uterine Arteriovenous Malformation

2021 ◽  
Vol 11 (9) ◽  
pp. 97-100
Author(s):  
Saima Najam ◽  
Syeda Ifra Hassan
Keyword(s):  
Arteriovenous Malformation ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Molar Pregnancy ◽  
Artery Embolization ◽  
Excessive Bleeding ◽  
Vascular Abnormalities ◽  
True Incidence ◽  
Suction Curettage ◽  
Life Threatening

Uterine vascular abnormalities though are not very common but are potentially life threatening as can lead to torrential vaginal bleeding. Although they are considered relatively rare, with fewer than 150 cases reported in the literature, a true incidence of the uterine AVM may be much higher. We are reporting a case which was diagnosed as molar pregnancy and suction curettage was done, at the time of the evacuation there was excessive bleeding which was immediately dealt with the tamponade by the Foleys catheter and the vaginal packs till the arrangements for the uterine artery embolization were done. At the time of embolization right uterine artery arteriovenous malformation was detected incidentally and embolized along with the uterine arteries. The post op recovery of the patient was uneventful. Retrospectively when the Doppler ultrasound was reassessed hypoechoic lesions and dilated veins were seen in the myometrium which were misdiagnosed as molar. In any patient if the myometrium shows dilated veins and on Doppler if abnormal active vessel flow with a coloured mosaic pattern is detected uterine AVM should be suspected and should be investigated further with the computed tomography (CT) for proper treatment of the patient and prevention of the life-threatening haemorrhage. Key words: Uterine artery embolization, haemorrhage, dilatation and curettage. Uterine AVM.

Bleeding Control in Palliative Care Patients With the Help of Tranexamic Acid

2017 ◽  
Vol 32 (2) ◽  
pp. 47-48 ◽  
Author(s):  
Marcus J. P. Geist ◽  
Jens Kessler ◽  
Susanne Frankenhauser ◽  
Hubert J. Bardenheuer
Keyword(s):  
Palliative Care ◽  
Tranexamic Acid ◽  
Palliative Medicine ◽  
Severe Bleeding ◽  
Evidence Based ◽  
Bleeding Control ◽  
Dosing Regimen ◽  
Case Presentation ◽  
Acute Bleeding ◽  
Optimal Dosing

Background: Persistent bleeding is a common reason for admitting patients with advanced cancer to a palliative care unit. Several reports show a successful therapeutic use of the antifibrinolytic agent tranexamic acid in palliative care patients having hemorrhages. However, it is not administered routinely in severe bleeding situations in palliative care, and general dosing recommendations are unclear. Case Presentation: We report on 3 patients who were treated with tranexamic acid due to symptomatic hemorrhage complicating different malignant processes. Case Management and Outcome: A dosing regimen of 1000 mg intravenous tranexamic acid 3 times a day caused an arrest of bleeding in the reported patients within 2 to 3 days. Having controlled the acute bleeding, we continued with an oral administration of 3000 mg per day as maintenance dose. Conclusions: The described dosing regimen was effective in controlling the symptomatic bleeding of the reported patients. Further studies are needed to get evidence-based information on the optimal dosing regimen of tranexamic acid and to emphasize its significance in palliative medicine.

scholarly journals A Fertility-Preserving Laparoscopic Management Combined With Hysteroscopy of Uterine Arteriovenous Malformation Followed by Uterine Arteries Embolization: A Case Report

2019 ◽  
Vol 7 (4) ◽  
pp. 531-534
Author(s):  
Jing Ouyang ◽  
Xia Wei ◽  
Siqin Yang ◽  
Yiru Shi ◽  
Shiqing Hu ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Uterine Artery Embolization ◽  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Laparoscopic Approach ◽  
Artery Embolization ◽  
Case Presentation ◽  
Uterine Arteries ◽  
Uterine Arteriovenous Malformation

Objectives: The current study presented a fertility-preserving laparoscopic approach combined with hysteroscopy for the treatment of a uterine arteriovenous malformation (AVM) after a failed uterine artery embolization (UAE). Case Presentation: The patient was diagnosed with acquired uterine AVM and underwent a UAE, followed with the recurrence of massive vaginal bleeding. The computed tomography angiography (CTA) demonstrated AVM neovascularization and the patient profoundly desired to preserve her fertility. Results: The patient underwent a laparoscopic surgery combined with hysteroscopy during which the supply vessels of the AVM were obliterated and a 3-month GnRHa regimen was prescribed accordingly. The follow-up CTA was performed at postoperative day 3 and month 5. Both of the obtained images indicated the remission of the AVM. Thus, the patient remained asymptomatic during a 18-month follow-up after the operation. Conclusions: In general, the laparoscopic obliteration of the supply vessels of the uterine AVM could provide an alternative to hysterectomy in patients whose embolization attempt failed and thus had a fertility-preserving desire.

scholarly journals Uterine Arteriovenous Malformation After Molar Pregnancy: A Case Report and Review of Literature

2017 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zohreh Yousefi ◽  
Meisam Izadi ◽  
Leila Mousavi Seresht ◽  
Nooshin Babapour ◽  
Hoda Bagheri
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Molar Pregnancy ◽  
Review Of Literature ◽  
Uterine Arteriovenous Malformation

Uterine arteriovenous malformation: a rare cause of abnormal uterine bleeding

2020 ◽  
Vol 179 (1-2) ◽  
Author(s):  
Joana Cominho ◽  
Inês Azevedo ◽  
Sofia Saramago ◽  
Ana Brandão ◽  
Isabel Serrano ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Uterine Arteriovenous Malformation
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