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Archives of Gynecology and Obstetrics

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01-11-2011 | General Gynecology

Uterine arteriovenous malformations induced after diagnostic curettage: a systematic review

Authors: Panagiotis Peitsidis, Emmanouil Manolakos, Vasiliki Tsekoura, Rolf Kreienberg, Lukas Schwentner

Published in: Archives of Gynecology and Obstetrics | Issue 5/2011

Abstract

Purpose

To perform an extensive systematic review to examine all the available literature reporting iatrogenic acquired arteriovenous malformation (AVM) induced after diagnostic curettage and to describe a further case of a 34-year-old woman presenting with acute vaginal bleeding due to AVM induced after uterine curettage for termination of pregnancy.

Methods

We searched the electronic databases: MEDLINE (1950–2011), Embase (1980–2011), Cochrane Library (2004–2011), Cinahl (1981–2011), Popline (2004–2011).

Results

Initial search extracted 333 relevant articles. Final assessment resulted to the inclusion of 91 studies, 85 case reports and 6 observational studies. Studies are dated between 1954 and 2011. A metanalysis of the 85 case reports reporting 100 patients was performed. The mean age of the women diagnosed with AVM was 30 ± 9.1 years, range (16–72) years, 96 women were premenopausal (96%) and 4 were postmenopausal (4%). Ultrasound imaging was applied in 86 patients (86%), and ultrasound combined with angiography was performed in 51 patients (51%). Uterine artery embolization (UAE) was the most common treatment option performed in 59 patients (59%). Total abdominal hysterectomy was performed in 29 patients (29%). Spontaneous resolution of AVM occurred in six patients (6%). In 17 patients (17%), recurrence occurred after treatment with UAE. Twenty-four articles reported pregnancies in 27 patients (27%).

Conclusion

Ultrasound imaging with appropriate knowledge of color Doppler features minimizes the use of inappropriate interventional procedures such as diagnostic curettage. UAE is effective in treatment, and rarely leads to complications.

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Title: Uterine arteriovenous malformations induced after diagnostic curettage: a systematic review
Authors: Panagiotis Peitsidis
Emmanouil Manolakos
Vasiliki Tsekoura
Rolf Kreienberg
Lukas Schwentner
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 5/2011
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2067-7

At a glance: The STEP trials

Springer Medicine

Uterine arteriovenous malformations induced after diagnostic curettage: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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