A Rare Case of Arteriovenous Malformation Presenting as Secondary Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is a life-threatening complication and is the leading cause of maternal mortality. We, present to you a case of a 30-year-old primigravida who conceived with in vitro fertilization (IVF) and presented to the emergency department at 31 weeks of gestation in active preterm labor with a history of fever. The patient delivered vaginally and was stable initially. However, the following day she had complaints of vaginal bleeding and developed signs of sepsis. She was then shifted to the ICU and consequently started on uterotonics and higher antibiotics. An urgent Ultrasound and CT angiography were performed which revealed arteriovenous malformation (AVM) and fistula. Uterine artery embolization was performed successfully to control the bleeding after the failure of conservative management.