Doctor Nguyen Thi Thanh Tam, from the Obstetrics and Gynecology Center at Tam Anh General Hospital Ho Chi Minh City, reported that Linh had an arteriovenous fistula within her uterine muscle, identified as a uterine arteriovenous malformation (AVM). Doctor Tam indicated that placental adherence might have caused this vascular malformation.

AVM is a serious vascular abnormality in the uterus. Normally, blood from arteries must pass through a capillary network to nourish organs before returning to veins. However, when an artery directly connects to a vein without passing through the capillary network, it creates an abnormal fistula. The uterine tissue bypassed by this direct flow does not receive nourishment and loses its function.

According to Doctor Phan Hoang Vinh Phu, from the Diagnostic Imaging and Interventional Radiology Center, untreated uterine AVM can disrupt in vitro fertilization (IVF) protocols due to hormonal fluctuations during ovarian stimulation. A pregnancy conceived with uterine AVM also carries a risk of early miscarriage due to abnormal bleeding.

Guided by a digital subtraction angiography (DSA) system, the medical team used a microcatheter to access the abnormal fistula. They then injected a specialized embolic material, Onyx, to block the fistula, preventing blood flow directly from the artery to the vein.

Doctor Phu explained that Onyx is a special material, easier to control than conventional glue because its slower adhesion rate allows for better technical manipulation. The most important goal is to seal the fistula. If only the feeding arteries are blocked and the fistula remains, there is a high risk of recurrence.

Doctor Phu performs uterine vascular malformation embolization on a patient. Photo: Tam Anh General Hospital

Doctor Phu performs uterine vascular malformation embolization on a patient. Photo: Tam Anh General Hospital

The intervention proceeded smoothly. After two days of hospitalization, Linh's health stabilized, with no vaginal bleeding. She recovered well and was discharged.

Uterine artery embolization is currently the optimal treatment for uterine arteriovenous malformations, helping prevent bleeding and preserve the uterus. This was also a crucial step for Linh to undergo IVF safely.

According to Doctor Tam, women who have undergone abortion or retained miscarriage evacuation, or have a history of abnormal uterine bleeding, should seek early examination to promptly detect uterine vascular malformations. Timely treatment helps prevent complications and preserve reproductive function.

Nhat Thanh

*Patient's name has been changed