Hysteroscopic Confirmation of a Uterine Arteriovenous Malformation as a Possible Cause of Recurrent Pregnancy Loss

This case report highlights the cornerstone role played by hysteroscopy to confirm a diagnosis of uterine arteriovenous malformations that was ambiguous with the imaging studies. A 30-year-old nulliparous woman who experienced three unexplained recurrent pregnancy losses was suspected of having a uterine arteriovenous malformation. The arteriovenous malformation was confirmed through hysteroscopy and managed with a multidisciplinary approach involving interventional radiology and reproductive specialists. The hysteroscopy was followed by uterine artery embolization, which resulted in the resolution of the arteriovenous malformation. A spontaneous pregnancy and live birth rapidly followed. Uterine arteriovenous malformations have been widely reported in gynecology as a consequence of the surgical treatment of a miscarriage or gestational trophoblastic disease. We suggest that they are also important to diagnose in patients presenting with recurrent pregnancy loss, where they represent a curable etiology.