Objective To discuss the clinical manifestations,diagnosis,treatment and prognosis of advanced postpartum hemorrhage with uterine arteriovenous fistula by analyzing clinical cases and consulting literature.Methods The clinical data of 11 patients with confirmed pathological dignnosis of advanced postpartum hemorrhage and uterine arteriovenous fistula admitted to the Women's Hospital of School of Medicine of Zhejiang University from January 2018 to May 2022 were analyzed.Results Among the 11 patients,8 patients had two or more pregnancies(72.7％);9 patients had a history of uterine operation(81.8％);1 patient had various clinical manifestations,and the postpartum bleeding time was 8-66(31.2±20.1)days after the termination of pregnancy,and vaginal bleeding was persistent,repetitive and sudden;obvious lesions could be seen under pelvic angiography;bilateral uterine artery embolization was performed,and vaginal bleeding was controlled 3 to 6 days after the operation;in the follow-up,3 patients had not recovered menstruation due to lactation,and 4 cases recovered regular in menstruation 1 to 4 months after surgery.Conclusions The acquired uterine arteriovenous fistula is closely related to the history of uterine operation.Vaginal bleeding is a common symptom of uterine arteriovenous fistula but lacks specificity.Clinical staff should comprehensively consider the patient's clinical manifestation,disease development and personal factors,identify conditions early,and implement the personalized treatment plan.
关键词
子宫动静脉瘘/产后出血/临床资料分析
Key words
uterine arteriovenous fistula/postpartum bleeding/clinical data analysis
维普
万方数据