A life-threatening event: Uterine cervical arteriovenous malformation

BACKGROUND: Uterine cervical arteriovenous malformation is a rare cause of vaginal bleeding. CASE: A 32-year-old multigravida presented with severe vaginal bleeding originating in the cervix, which resulted in a hypovolemic shock. Attempts to control the bleeding included hysterectomy, pelvic arterial embolization, and upper vaginectomy. Each proved unsuccessful. Histopathologic examination revealed an arteriovenous malformation. Despite local packing, suturing of the vault area, and brachytherapy to the vaginal vault, bleeding persisted. Treatment with GnRH agonist and tranexamic add stopped the bleeding. CONCLUSION: Severe vaginal bleeding can be the result of cervical arteriovenous malformation, and GnRH agonist may be used for treatment. (C) 2004 by The American College of Obstetricians and Gynecologists.