UTERINE CERVICAL ARTERIOVENOUS MALFORMATION- A CAUSE OF LIFETHREATENING UTERINE HAEMORRHAGE

BACKGROUND-Arteriovenous malformation of the uterine cervix is a rare entity. Its paucity is established in the gynaecologic literature. That does not detract, however, from diagnostic and therapeutic difficulties encountered by the gynaecologist faced with the serious problem of haemorrhage and its sequelae. Uterine bleeding is the most common presentation. Most reported cases have been treated by hysterectomy. Unlike with the more common causes of excessive uterine bleeding, curettage is not therapeutic in uterine cervical arteriovenous malformation and may aggravate the bleeding. It also does not respond to hormonal therapy. Clinical findings are not informative. In the past, diagnosis was usually made only at laparotomy or after examination of the hysterectomy specimen. CASE -We present a case of arteriovenous malformation of the uterine cervix. A 23 year old parous lady was admitted with history of severe vaginal bleeding originating in the cervix, which resulted in hypovolemic shock. Local pathology was ruled out. Bleeding could not be controlled with routine medical measures and vaginal packing. Hysterectomy had to be done to control the bleeding. Histopathological examination revealed an arteriovenous malformation of cervix.CONCLUSION-Severe vaginal bleeding can be the result of cervical arteriovenous malformation, and hysterectomy can be used as a last resort.