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Uterine Arteriovenous Malformations: A Review of the Current Literature

Grivell, Rosalie M BM, BS*; Reid, Kym M. BM, BS; Mellor, Amy MBBS

Obstetrical & Gynecological Survey: November 2005 - Volume 60 - Issue 11 - p 761-767
doi: 10.1097/01.ogx.0000183684.67656.ba
CME Program: CATEGORY 1 CME REVIEW ARTICLES 30, 31, 32, and 33: CME REVIEW ARTICLE 33
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CME

Uterine arteriovenous malformation (AVM) is a rare but potentially life-threatening condition. AVMs often present with intractable bleeding and commonly are seen in association with pregnancy and uterine trauma. Ultrasound is the most common form of initial investigation, and computed tomography and magnetic resonance imaging are being used with greater frequency. Despite this, angiography remains the gold standard for diagnostic evaluation. Embolization has become a more acceptable form of treatment and allows more invasive forms of treatment, particularly hysterectomy, to be avoided. Numerous medical therapies have also been used in the management of patients with uterine AVM. Reports of successful pregnancies after diagnosis and treatment of a uterine AVM are still uncommon, but increasingly good outcomes are being reported after successful treatment of a confirmed uterine AVM.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to describe the many and varied clinical manifestations of a uterine arteriovenous malformation (AVM), summarize the best ways to manage an acute hemorrhage from an AVM, and identify the current best way to diagnose an AVM.

*Obstetrics, Gynaecology Registrar, Department of Perinatal Medicine, Women’s and Children’s Hospital, Adelaide, South Australia, Australia; †Obstetrics and Gynaecology Registrar, Department of Perinatal Medicine, Women’s and Children’s Hospital, Adelaide, South Australia, Australia; and ‡Obstetrics and Gynaecology Registrar, Department of Perinatal Medicine, Women’s and Children’s Hospital, Adelaide, South Australia, Australia

Chief Editor’s Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA category 1 credit hours can be earned in 2005. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

This CME activity is supported by an unrestricted educational grant from Procter & Gamble.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

Wolters Kluwer Health has identified and resolved all faculty conflicts of interest regarding this educational activity.

Reprint requests to: Kym M. Reid, BM, BS, Department of Perinatal Medicine, Women’s and Children’s Hospital, Adelaide, South Australia, 5006, Australia. E-mail: kym.reid@internode.on.net.

© 2005 Lippincott Williams & Wilkins, Inc.