Malformação arteriovenosa uterina como causa de hemorragia pós parto: relato de caso e revisão de literatura

Abstract

About 0.5% of the proposed deliveries are cases of secondary puerperal hemorrhage, 5% mostly between one and two weeks after delivery. The most common causes are that there are less common places, bed subinvolution and infectious causes, but there are less common causes, of uncertain prevalence, such as arteriovenous malformations (AVM). AVMs are the result of the formation of arteries and veins with fistulous channels and shunts with myometrial capillaries. Clinical manifestations are metrorrhagia and menometrorrhagia, lower abdominal pain, dyspareunia and anemia. Diagnosis is made by transvaginal Doppler ultrasound, arteriography, and contrast-enhanced MRI. The present study is a case report that aims to demonstrate a patient with late puerperal hemorrhage with imaging suggesting uterine arteriovenous malformation as the cause and its clinical management, hemodynamic stabilization, and definitive treatment to resolve the condition. As we do not have more similar cases in the literature, this report is of paramount importance to alert gynecologists and obstetricians and obstetricians of diagnostic planning for patients with similar symptoms to establish treatment and appropriate treatment.