Clinical Analysis Of Uterine Arteriovenous Fistula

Objective: Through the literature retrieval and analysis of the clinical data of uterine arteriovenous fistula,the clinical characteristics of uterine arteriovenous fistula were determined to provide theoretical basis for early diagnosis and clinical treatment of the disease in the future.Methods: By using the method of literature retrieval,the relevant literatures were searched on the databases of China Knowledge Network,Wanfang and PubMed,and the literatures related to the disease were systematically reviewed in combination with clinical practice.By using the method of case analysis,the clinical data of three cases of uterine arteriovenous fistula treated in the Affiliated Hospital of Yanbian University from July 2020 to November 2021 were retrospectively analyzed,such as color ultrasound scanning,pelvic MRI and imaging diagram of uterine arterial embolization(UAE).The similarities and differences in medical history,clinical manifestations,diagnosis and treatment process and prognosis were compared.Results: Through systematic literature search,the pathogenesis of uterine arteriovenous fistula was not clear and the clinical manifestations were not typical.It could be diagnosed by color ultrasound scanning,uterine adnexal CT and pelvic MRI,and should be distinguished from other diseases with vaginal bleeding as the main symptoms.Conservative treatment,UAE and surgical treatment could be selected.All the 3 patients were women of childbearing age,the average age of onset was 36 years old(29-44 years old),and had a history of iatrogenic uterine operation(including artificial abortion or curettage,vaginal delivery,myomectomy,etc.).There was a lack of consistency in clinical manifestations.Vaginal bleeding was the main symptom in 2 cases and future menstruation in 1 case.All the 3patients were screened by color ultrasound scanning,which could show that there were rich red and blue mosaic blood flow signals in the anechoic area."colorful mosaic" or "lake",1 case was diagnosed and treated conservatively with drugs,2cases were diagnosed as uterine arteriovenous fistula by further examination,and uterine artery embolization was performed.Good recovery,no vaginal bleeding and other uncomfortable symptoms,the prognosis was good.Conclusion: The etiology of acquired uterine arteriovenous fistula was not clear,and iatrogenic invasive uterine operation might be the main cause of the disease.Color Doppler Flow Imaging of blood flow resistance changes was the basis for the diagnosis of uterine arteriovenous fistula.If necessary,uterine adnexal CT or pelvic MRI should be performed to avoid missed diagnosis.Uterine artery embolization was the first choice for the treatment of uterine arteriovenous fistula,but mild patients could be treated with progesterone and GnRH-a.