What to learn from a case of short-term pregnancy after uterine artery embolization for acquired uterine arteriovenous malformation

Introduction:Acquired uterine arteriovenous malformations are rare causes of bleeding occurring after uterine curettage, gestational disease, abortion, or delivery.Uterine artery embolization is a safe and effective procedure to treat bleeding, although outcomes on fertility and subsequent pregnancy are yet to be defined.Case Report: A 34-year-old nulliparous woman underwent medical treatment with misoprostol for first trimester miscarriage.After two weeks a transvaginal ultrasound found a round myometrial lesion with hypoechoic spaces, abundant vascularization suggestive of an acquired uterine arteriovenous malformation.A conservative management was adopted with ultrasound follow-up.Twenty days later a severe bleeding occurred and the patient was treated with bilateral uterine artery embolization.After three months the patient got pregnant and gave birth at term to a healthy and normal weight baby.Third stage of labor was complicated by placental retention requiring manual removal and postpartum hemorrhage managed with uterine hemostatic balloon positioning and blood transfusion.