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Is It Possible To Conceive After Suffering Uterine Arteriovenous Malformation After C Section?
Question: I had a uterine avm after my c section... I hemoraged 4 times ...i apparently heeled on my own.its been a yr now and i was to try for another baby? Any thoughts
I hemmoraged 8 weeks later and then every 2 weeks 4 times
I hemmoraged 8 weeks later and then every 2 weeks 4 times
Brief Answer:
Once avm has healed you can definitely plan for another baby.
Detailed Answer:
Hi,
Weicome to Healthcare Magic.
I am Dr Ramadevi wani. I will be answering your concerns today.
It is a great relief to know that the uterine avm is healed. How do you know that it is healed? Did you take medications like GnRH analogues?
Having normal mensus does not confirm that it has healed.
At first it is important that you have colour Doppler ultrasound by a good Radiologist to make sure that the AVM has healed. If it has not healed you need to be treated for it. The type of treatment depends on the size of malformation. Smaller avms can be treated with medicines and larger ones will need uterine artery embolization.
Once avm has healed you can definitely plan for another baby. As you know uterine avm is a rare condition. But the evidence in the literature is very reassuring. No catastrophic complications of pregnancy and labor occurred in women who conceived after the avm was treated/resolved.
I hope this helps. Good luck.
If you have any further queries do write to me through Healthcare magic. I will be happy to answer.
Once avm has healed you can definitely plan for another baby.
Detailed Answer:
Hi,
Weicome to Healthcare Magic.
I am Dr Ramadevi wani. I will be answering your concerns today.
It is a great relief to know that the uterine avm is healed. How do you know that it is healed? Did you take medications like GnRH analogues?
Having normal mensus does not confirm that it has healed.
At first it is important that you have colour Doppler ultrasound by a good Radiologist to make sure that the AVM has healed. If it has not healed you need to be treated for it. The type of treatment depends on the size of malformation. Smaller avms can be treated with medicines and larger ones will need uterine artery embolization.
Once avm has healed you can definitely plan for another baby. As you know uterine avm is a rare condition. But the evidence in the literature is very reassuring. No catastrophic complications of pregnancy and labor occurred in women who conceived after the avm was treated/resolved.
I hope this helps. Good luck.
If you have any further queries do write to me through Healthcare magic. I will be happy to answer.
Above answer was peer-reviewed by :
Dr. Raju A.T
They are assuming i am healed comsidering the last year nothing has happened anymore.... I had 2 angiograms when i last hemmoraged... The first one they saw somethjnf very small which they assumed was a avm but their tools couldnt get to it to embolize it so they transferred me to another hospital when they did the anguogram they said there was nothing there to show an avm... They also saw ghat the previous hospital punctured me when they did an angiogram so it formed a blood clot but thank god my body remaped a way to have enough blood flow to my leg so i am cleared frlm that tragedy from vascualr. Because they didnt see anything they did treat me they were going to give me menopause shots but i told them i wasnt comfortable and i wanted to wait and thank god so far in a year no hemmoraging and normal periods...i am nervous if i have another baby as my uterus expands again will i hemmorage?! I am trully pertrofied of bleeding to death
Brief Answer:
If the avm has disappeared you can definitely plan for another baby.
Detailed Answer:
Hi,
Welcome back.
I do appreciate your concerns.
Angiography is the gold standard for diagnosis of uterine avm. If they could not see anything in angio, it means that it probably has healed/disappeared.
Yet keeping in mind the seriousness of the condition I advise you to have one colour Doppler ultrasound to reaffirm that the avm has disappeared.
As I wrote earlier, this condition is very rare. Less than 100 cases of pregnancy after treatment of uterine arteriovenous malformation have been described in medical literature. As mentioned before the report is very reassuring. These women had uncomplicated pregnancies and delivery.
In my opinion if the avm has disappeared you can definitely plan for another baby. Below I am attaching the abstract of the literature published in the journal. This would help you make a decision for yourself.
Abstract
Purpose: To perform a retrospective audit of cases of uterine arteriovenous malformations (UAVM) at The Canberra Hospital and review of recent literature reporting pregnancies occurring after the diagnosis of UAVM aiming to devise a diagnostic and treatment protocol to optimise pregnancy post UAVM.
Methods: A retrospective audit of cases of UAVM at the Canberra Hospital from a prospectively managed patient database was performed. A search of the electronic database PubMed, for articles between 2000-2011 relating to pregnancy post UAVM. Individual case studies were analysed separately to case series.
Results: The study included 28 individual studies and five case series (61 women). Average age was 29.5 ± 6.7 (range 18–42). Most women (24, 85.7%, 100% in case series) presented with abnormal vaginal bleeding; 11 (41%) individuals presented post interruption of pregnancy. All women had had a previous pregnancy (mean gravidity 3.1 ± 3.1, range 1–15 for case studies) and only four women (14.2 %) had no history of uterine trauma. Only one woman (3.6 %) did not have any ultrasound and most women underwent colour Doppler ultrasonography (20, 71.4% in case studies; 61, 83.6% in case series). Of the women, 72 (53.6 % of case studies, 78.1% of case series) were treated with uterine artery embolisation, seven (25%) were treated expectantly. A total of 63 pregnancies occurred post treatment, seven (13.9%) ending in miscarriage. Average time to conceive post diagnosis was 19 months ± 16.3 (range 2–72). A total of 54 healthy infants were born to mothers post AVM diagnosis.
Conclusion: UAVM are likely to exist on a continuum with other pregnancy related pathologies, such as sub involution of the placental bed, making a single best diagnostic and treatment plan difficult. However, this study shows that successful uncomplicated pregnancy is achievable for women after the diagnosis of UAVM.
I hope this helps. My best wishes to you.
If you have any further queries do write to me through Healthcare magic. I will be happy to answer.
If the avm has disappeared you can definitely plan for another baby.
Detailed Answer:
Hi,
Welcome back.
I do appreciate your concerns.
Angiography is the gold standard for diagnosis of uterine avm. If they could not see anything in angio, it means that it probably has healed/disappeared.
Yet keeping in mind the seriousness of the condition I advise you to have one colour Doppler ultrasound to reaffirm that the avm has disappeared.
As I wrote earlier, this condition is very rare. Less than 100 cases of pregnancy after treatment of uterine arteriovenous malformation have been described in medical literature. As mentioned before the report is very reassuring. These women had uncomplicated pregnancies and delivery.
In my opinion if the avm has disappeared you can definitely plan for another baby. Below I am attaching the abstract of the literature published in the journal. This would help you make a decision for yourself.
Abstract
Purpose: To perform a retrospective audit of cases of uterine arteriovenous malformations (UAVM) at The Canberra Hospital and review of recent literature reporting pregnancies occurring after the diagnosis of UAVM aiming to devise a diagnostic and treatment protocol to optimise pregnancy post UAVM.
Methods: A retrospective audit of cases of UAVM at the Canberra Hospital from a prospectively managed patient database was performed. A search of the electronic database PubMed, for articles between 2000-2011 relating to pregnancy post UAVM. Individual case studies were analysed separately to case series.
Results: The study included 28 individual studies and five case series (61 women). Average age was 29.5 ± 6.7 (range 18–42). Most women (24, 85.7%, 100% in case series) presented with abnormal vaginal bleeding; 11 (41%) individuals presented post interruption of pregnancy. All women had had a previous pregnancy (mean gravidity 3.1 ± 3.1, range 1–15 for case studies) and only four women (14.2 %) had no history of uterine trauma. Only one woman (3.6 %) did not have any ultrasound and most women underwent colour Doppler ultrasonography (20, 71.4% in case studies; 61, 83.6% in case series). Of the women, 72 (53.6 % of case studies, 78.1% of case series) were treated with uterine artery embolisation, seven (25%) were treated expectantly. A total of 63 pregnancies occurred post treatment, seven (13.9%) ending in miscarriage. Average time to conceive post diagnosis was 19 months ± 16.3 (range 2–72). A total of 54 healthy infants were born to mothers post AVM diagnosis.
Conclusion: UAVM are likely to exist on a continuum with other pregnancy related pathologies, such as sub involution of the placental bed, making a single best diagnostic and treatment plan difficult. However, this study shows that successful uncomplicated pregnancy is achievable for women after the diagnosis of UAVM.
I hope this helps. My best wishes to you.
If you have any further queries do write to me through Healthcare magic. I will be happy to answer.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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