{
    "abstract": "Uterine arteriovenous malformations (UAVMs) that occur after birth are a rare cause of late postpartum hemorrhage. Acquired UAVMs usually occur in conjunction with pathology of the placenta. In the spectrum of placenta accreta (PAS), subinvolution of the placental bed plays an important role in its pathophysiology. We present a case of UAVM in a pregnant woman with PAS who presented with marked metrorrhagia after delivery, which was treated with classical management. Then, 35 days later, she presented to the emergency room with severe metrorrhagia. As it was suspected that she had placental remnants, an instrumental uterine control was performed, but the bleeding persisted, requiring further uterine packing and blood administration. Later, uterine artery embolization was performed with good results. Color Doppler ultrasound, magnetic resonance imaging, and angiography were the methods with the greatest diagnostic value. The differential diagnosis was as complex as the treatment. We hypothesize that UAVM may develop from minimal residual PAS in this late postpartum period. Moreover, they may recover rapidly after local surgical ablation. Considering the clinical condition, hemodynamic status, and desire to preserve fertility, we were able to avoid a hysterectomy, which is often chosen in such cases of severe, life-threatening bleeding complications.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, University of Medicine and Pharmacy, 200143 Craiova, Romania.\nDepartment of Obstetrics, Gynecology and IVF, HitMed Medical Center, 200130 Craiova, Romania.",
            "firstname": "Constantin-Cristian",
            "initials": "CC",
            "lastname": "Vaduva"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, University of Medicine and Pharmacy, 200143 Craiova, Romania.\nDepartment of Obstetrics, Gynecology and IVF, HitMed Medical Center, 200130 Craiova, Romania.",
            "firstname": "Laurentiu",
            "initials": "L",
            "lastname": "Dira"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, University of Medicine and Pharmacy, 200143 Craiova, Romania.",
            "firstname": "Sidonia Maria",
            "initials": "SM",
            "lastname": "Sandulescu"
        },
        {
            "affiliation": "Department of Radiology, County Clinical Emergency Hospital, University of Medicine and Pharmacy, 200642 Craiova, Romania.",
            "firstname": "Cristian",
            "initials": "C",
            "lastname": "Constantin"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Victor Babe\u0219 University of Medicine and Pharmacy, 300041 Timisoara, Romania.\nClinic of Obstetrics and Gynecology, \"Pius Brinzeu\" County Clinical Emergency Hospital, 300723 Timisoara, Romania.\nCenter for Laparoscopy, Laparoscopic Surgery and In Vitro Fertilization, Victor Babe\u0219 University of Medicine and Pharmacy, 300041 Timisoara, Romania.",
            "firstname": "Elena Silvia",
            "initials": "ES",
            "lastname": "Bernad"
        },
        {
            "affiliation": "Department of Anatomy, University of Medicine and Pharmacy, 200349 Craiova, Romania.",
            "firstname": "Dana Maria",
            "initials": "DM",
            "lastname": "Albulescu"
        },
        {
            "affiliation": "Department of Pathology, Filantropia Clinical Hospital, University of Medicine and Pharmacy of Craiova, 200143 Craiova, Romania.",
            "firstname": "Mircea-Sebastian",
            "initials": "MS",
            "lastname": "Serbanescu"
        },
        {
            "affiliation": "Department of Microbiology, County Clinical Emergency Hospital, University of Medicine and Pharmacy, 200642 Craiova, Romania.",
            "firstname": "Lidia",
            "initials": "L",
            "lastname": "Boldeanu"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.3390/diagnostics14222538\n10.2147/IJWH.S224191\n10.1097/AOG.0000000000001005\n10.1016/j.ogc.2012.12.002\n10.1016/j.jmig.2012.12.008\n10.1007/s11604-017-0687-y\n10.1097/AOG.0000000000000812\n10.26611/10151417\n10.1016/j.ajog.2017.05.067\n10.21886/2219-8075-2022-13-4-58-65\n10.1080/14767058.2019.1570494\n10.1016/j.ajog.2011.01.001\n10.4274/tjod.galenos.2022.34683\n10.5858/2006-130-1538-SOTPSA\n10.1016/S0301-2115(00)00443-7\n10.1016/j.radcr.2023.08.035\n10.3390/ijms25031789\n10.3390/medicina59040715\n10.5603/GP.a2018.0047\n10.7759/cureus.18162\n10.7205/MILMED-D-14-00145\n10.3174/ajnr.A3529\n10.1186/s42155-021-00277-9\n10.4236/ojog.2021.1111146\n10.1148/radiology.186.1.8416592\n10.1038/labinvest.3780099\n10.1002/uog.18954\n10.7863/ultra.15.14.10050\n10.1007/s00404-013-2992-8\n10.1097/00006534-198203000-00002\n10.1002/uog.159\n10.1002/uog.163\n10.1097/00004728-200301000-00016\n10.1016/0002-9378(83)90237-5\n10.1111/jog.13939\n10.1016/j.fertnstert.2021.05.095\n10.1016/0029-7844(96)00122-6\n10.1002/uog.148\n10.1097/01.AOG.0000665612.09530.f8\n10.1016/j.diii.2016.09.003\n10.1148/rg.2017160128\n10.1016/j.eurox.2023.100220\n10.3390/jpm12071098\n10.3390/diagnostics14111084\n10.47391/JPMA.246\n10.3109/13645706.2015.1074082\n10.1016/j.ijgo.2004.11.037\n10.1016/j.ejvs.2006.01.004\n10.7863/jum.2006.25.11.1387\n10.1016/S1701-2163(16)32401-X\n10.1016/j.tjog.2021.06.001",
    "journal": "Diagnostics (Basel, Switzerland)",
    "keywords": [
        "case report",
        "color Doppler ultrasound (CDUS)",
        "placenta accreta spectrum (PAS)",
        "postpartum hemorrhage (PPH)",
        "uterine arteriovenous malformation (UAVM)",
        "uterine artery embolization (UAE)"
    ],
    "methods": null,
    "publication_date": "2024-11-27",
    "pubmed_id": "39594204\n33204176\n26244528\n23466142\n23352580\n29052024\n25923029\n37401294\n27833989\n38349501\n28599899\n30700221\n21349491\n35453952\n35770489\n17090198\n10986453\n37670915\n33807766\n38339066\n37109673\n30084480\n35284958\n34584814\n25562882\n24701531\n23620072\n34902107\n8416592\n10879746\n29124818\n26254150\n23934243\n7063565\n12808674\n12808667\n12544249\n6650623\n14551016\n30788888\n34130801\n8841239\n12808679\n27776896\n35108800\n28696852\n37636521\n28980065\n35887595\n38893611\n14550998\n34057969\n26330086\n15847873\n16478673\n17060424\n17346497\n35779926",
    "results": null,
    "title": "Case Report of Placenta Accreta Spectrum and Arteriovenous Malformations with Successful Preservation of Fertility After Birth.",
    "xml": "<Element 'PubmedArticle' at 0x7885037294e0>"
}