Uterine Arteriovenous Malformations (AVM): A Rare Cause of Abnormal Uterine Bleeding

BACKGROUND: Uterine arteriovenous malformations are a very rare, but life-threatening cause of uterine bleeding. Difficulty recognizing the presentation likely leads to misdiagnosis and underreporting. CASE: A 20-year-old woman with a recent history of a spontaneous abortion presented to the ER for loss of consciousness and heavy vaginal bleeding. Doppler imaging reflected increased vascularity extending down to the endometrium. The patient underwent a unilateral uterine artery embolization. CONCLUSION: Uterine AVM should be considered in reproductive age women with a recent history of pregnancy that present with heavy vaginal bleeding. Doppler imaging is a useful screening tool. Angiography confirms the diagnosis, provides a method of definitive treatment, and should be used in patients when Doppler imaging cannot exclude the presence of an AVM.