1.Fertility preserving surgical approach to uterine arteriovenous malformation
Mirah D. Borja ; Sheryl Ann B. Dela Cruz ; German II D.C. Tan-Cardoso
Philippine Journal of Obstetrics and Gynecology 2020;44(1):33-38
Arteriovenous malformations (AVM) are vascular disorders with a mixture of arterial, venous and small capillary-like channels with fistulous connections. Uterine arteriovenous malformations are rare cause of abnormal uterine bleeding with only a few reported cases. They may arise from pregnancy, miscarriage, previous cesarean section or other uterine surgery and gestational trophoblastic disease. Diagnosis can be made through angiography or doppler ultrasonography. Traditionally, uterine AVMs are treated with hysterectomy but with the advances in technology, minimally invasive conservative approaches such as radiologic arterial embolization or laparoscopic uterine artery ligation have become available.
We present a case of a 29-year-old, G2P1 (1011) who had a three- month history of heavy, intermittent vaginal bleeding from uterine arteriovenous malformation after a miscarriage. Laparoscopic bilateral uterine artery occlusion, offered a minimally invasive treatment with high symptomatic effectiveness.
Uterine Artery
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Arteriovenous Malformations
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Uterine Diseases
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Ligation
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Uterine Hemorrhage
2.Inside out: A successful repositioning of a chronic third-degree uterine inversion
Maria Angela B. Ocampo ; German D. Tan-Cardoso II
Philippine Journal of Obstetrics and Gynecology 2021;45(6):256-261
In this day and age, with the advancement of treatments and the strong campaign to discourage home deliveries, chronic uterine inversion is now considered an uncommon but life-threatening obstetric condition. In this report, we present a case of a 17-year-old primipara, who sought consultation due to prolonged and heavy vaginal bleeding. Upon speculum examination, a knob-like, fleshy, hyperemic, smooth mass, approximately 6 cm × 5 cm × 4 cm, was seen occupying the upper third of the vaginal canal. On internal examination, a globular mass was felt protruding through the cervix, which bleeds easily on manipulation. Uterine corpus was neither appreciated on both abdominal and rectovaginal examination. The patient was admitted and managed as a case of chronic uterine inversion, which was further confirmed by a sonogram. Successful repositioning of the uterus was achieved after trying different established techniques and procedures in the attempts at maneuvering the chronically inverted uterus.
Uterine Inversion