Vascular malformations in relation to obstetrics and gynaecology: diagnosis and treatment

Key content• Acquired uterine artery and congenital uterine arteriovenous malformations are rare but are associated with intractable uterine haemorrhage and increased maternal morbidity and mortality if not diagnosed early. • A high index of suspicion is required to make a timely diagnosis. • Haemorrhages resulting from acquired uterine artery and congenital uterine arteriovenous malformations are associated with a previous history of obstetric or gynaecological surgery. • Ultrasound can be key in diagnosing and localising these lesions before angiography. • Selective uterine artery embolisation is the treatment of choice.Learning objectives• To understand how uterine artery malformations are acquired and potential methods of prevention. • To recognise the clinical presentations of these lesions. • To note the role of ultrasound and colour Doppler examination in their diagnosis. • To identify appropriate management strategies.Ethical issues• Early diagnosis prevents unnecessary intervention such as evacuation of retained products of conception and use of antibiotics in cases of postpartum haemorrhage, or even hysterectomy. • Selective uterine artery embolisation appears to preserve ovarian function.Please cite this article as: Abu‐Ghazza O, Hayes K, Chandraharan E, Belli AM. Vascular malformations in relation to obstetrics and gynaecology: diagnosis and treatment. The Obstetrician & Gynaecologist 2010;12:87–93.