A Rare Case of Uterine Arteriovenous Malformation Following a Cesarean Scar Ectopic Pregnancy

Uterine arteriovenous malformations (UAVMs) are rare, life-threatening conditions characterized by abnormal communications between uterine arteries and veins, often resulting in severe hemorrhage. This report discusses the case of a 32-year-old woman living in rural Australia, who experienced an acute life-threatening per vaginal bleed following uterine artery embolization (UAE) for an UAVM associated with a cesarean scar ectopic pregnancy. The patient's rural residence posed significant challenges, including delayed access to specialized care and prolonged travel distances. Despite UAE, she experienced a recurrence of hemorrhage and life-threatening blood loss and required emergency interventions, leading to a hysterectomy. This case highlights the lethality of UAVM, the risks of recurrence after UAE, and the importance of close post-procedural monitoring, particularly for patients in remote areas. It also emphasizes the need to incorporate social factors such as rurality into management decisions, advocating for systemic solutions to support high-risk patients.