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| Clinical analysis of 16 women with secondary uterine arteriovenous fistula caused by incomplete abortion |
| Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University，Beijing Maternal and Child Health Care Hospital，Beijing , 100026 |
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Abstract To analyze the clinical characteristics, diagnosis, and treatment of the women with secondary uterine arteriovenous fistula (UAVF) caused by incomplete abortion. Methods: The clinical data of 16 women with secondary UAVF caused by incomplete abortion from January 2016 to October 2020 were analyzed retrospectively. Results: The duration from abortion to UAVF onset was (67.1±28.4) d, and there were 15 women with different degree of vaginal bleeding, and among them, there were 7 women were emergency admission due to sudden vaginal profuse bleeding. The mass size and RI by ultrasound were 34.0±11.8 mm and 0.3±0.2. The blood β-HCG level of these women was 20.6 (4.8-119.0) U/L, and the hemoglobin of these women when admission was 106.8±21.3g/L. There were 15 women had undergone uterine artery embolization (UAE) and hysteroscopy, and only one of them then had undergone total open hysterectomy after UAE. 6 women were found as the abnormal position of residual embryo, and the degeneration of villi tissues of these 6 women were found in postoperative pathology. The characteristics of patients with vaginal hemorrhage during conservative or expectant treatment included larger gestational age and residual embryo diameter, more abortion-related complications, lower hemoglobin level and longer hospital stay (P<0.05).Conclusion: UAVF of the women maybe occur when embryonic remains after incomplete abortion. The vaginal profuse bleeding of the women with higher gestational weeks when abortion, the women with more residual embryo, or the women with abortional complication should be guarded carefully. Hysteroscopic lesion resection after UAE for these women is one kind of safe and effective treatment.
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