Main Article Content

Abstract

Objective: To retrospectively review imaging findings and the outcomes of uterine artery embolization (UAE) in symptomatic uterine vascular anomalies. Methods: We identified 15 cases of acquired uterine vascular anomaly from 2010 to 2020 who were evaluated with ultrasound, computed tomography, and magnetic resonance imaging, either alone or in combination. All patients had history of dilatation and curettage or uterine instrumentation. They underwent angiography and embolization of the uterine arteries. Primary outcome post embolization was assessed clinically and/or in combination with ultrasound. Post procedure pregnancies were also recorded. Results: Non-invasive imaging was abnormal in all patients, however this pre intervention imaging was unable to accurately classify the type of vascular anomaly except in the case of pseudoaneurysm. Conventional angiography showed uterine artery hyperemia in 6, arteriovenous malformation in 7 and pseudoaneurysm in 2 patients. The technical success rate was 100% with no repeat embolization needed. Follow up ultrasound in 12 patients revealed resolution of abnormal findings, remaining three were normal on clinical follow up. Seven patients (46.7%) had a normal pregnancy, 15.7 months after the procedure (range 4-28 months). Conclusion: UAE is a safe and effective management option for intractable severe bleeding in patients with uterine vascular anomaly post instrumentation and is seen not to impair future pregnancy.


Keywords: Uterine artery embolization; Pseudoaneurysm; Arteriovenous malformation; Ultrasound; Computed tomography; Magnetic resonance imaging.

Article Details

How to Cite
Fatima, K., Zubairi, M. B., Azeemuddin, M., & Sayani, R. (2022). Acquired Uterine Vascular Anomaly: Experience from a tertiary care center in Pakistan. Sultan Qaboos University Medical Journal, 1(1). https://doi.org/10.18295/squmj.1.2022.006