Uterine Arteriovenous Malformation Following Molar Pregnancy-A Case Report

Abstract

Introduction Uterine Artery malformation (AVM) is a rare but potentially life threatening complication with less than 100 cases reported in the literature. It may be congenital or acquired. Materials and Methods We report a case of a 19 year old lady referred with irregular bleeding following evacuation of vesicular mole. Her serum beta hcG levels were in the rising trend, after an initial fall, after the evacuation, with CT chest showing multiple discrete nodules in bilateral lower lobe of lung, giving a picture of metastatic trophoblastic disease. Ultrasound showed multiple cystic spaces with  increased vascularity in posterior myometrium. MRI of the pelvis showed multiple dilated aneurysmal vessels of 5-18 mm seen at the uterine fundus and posterior myometrium suggesting uterine A-V malformation. Repeat CT of the chest showed non calcified nodule in the posterior basal segment of the right lower lobe with arterial feeder from right pulmonary artery suggesting pulmonary AV malformation. As the patient was a nullipara , uterine artery embolisation was done for preservation of future fertility. Conclusion Acquired uterine artery malformation is rare, even more, in our case there is a suspicion of associated pulmonary AV malformation. DC causes life threatening bleeding and high index of suspicion is needed in such cases.