Postpartum Uterine Arteriovenous Fistula

In Brief BACKGROUND: Uterine arteriovenous communications are uncommon lesions that may be associated with life-threatening postpartum and postinstrumentation hemorrhage. CASE: A primigravida presented with infected retained products of conception. Excessive hemorrhage of unclear etiology occurred at dilation and curettage. After a second episode of bleeding, the patient received a diagnosis of uterine arteriovenous fistula. CONCLUSION: Uterine arteriovenous communications should be included in the differential diagnosis in patients with excessive postpartum or postinstrumentation bleeding. Color and spectral flow Doppler can aid diagnosis and clinical management. Uterine arteriovenous malformations/fistulae should be considered in the evaluation of uterine hemorrhage, and radiologic imaging with color and spectral flow Doppler can be diagnostic.