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KMID : 0877920100120030157
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Korean Journal of Ultrasound in Obstetrics and Gynocology
2010 Volume.12 No. 3 p.157 ~ p.162
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Diagnosis and Management of Uterine Arteriovenous Malformation
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Jo Yun-Sung
Yoon Joo-Hee
Choi Hyun-Joo
Lee Gui-Se-Ra
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Abstract
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Objective: To describe our experience with diagnosis and management of cases with different clinical presentations of uterine arteriovenous malformations (uAVM).
Methods: A retrospective review of 13 patients who were diagnosed with uAVM at our institution between 1995 and 2009 was performed.
Results: Mean age of the patients was 31.00±5.58 years (21~39 years). Assumed etiology was cesarean section (6 cases, 46.1%), abortion (5 cases, 38.5%), gestational trophoblastic disease (2 cases, 15.4%). Ultrasound, CT and MRI are effective in diagnosis of uAVM. The patients were confirmed uAVMs with clinical manifestations, catheter angiography or postoperative pathologic results. Four patients (30.8%) underwent total hysterectomy, eight patients (61.5%) underwent percutaneous embolization of uterine arteries and one patient (7.7%) was treated conservatively.
Conclusion: Clinical symptom such as delayed profuse vaginal bleeding after repeat cesarean section and D and C (dilatation and curettage) is one of clues for uAVM and imaging study with color Doppler and CT/MRI is very useful and convenient tool in diagnosis of uAVM. The choice of treatment depended on the patients’ vital sign, age and plan of future pregnancy.
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KEYWORD
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Uterine arteriovenous malformations, Imaging study, Hysterectomy, Uterine arteries embolization
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