A reclassification and comprehensive examination of uterine arteriovenous malformation: insights derived from a case series

Uterine arteriovenous malformation (UAVM) is a rare cause of vaginal bleeding in women of childbearing age. Due to the rarity of UAVM, previous studies have classified UAVM into primary and secondary types based on whether the uterus has been traumatized, but this classification method is overly simplistic. Meanwhile, there is a lack of systematic understanding of its pathological mechanisms, clinical manifestations, imaging manifestations, differentiation, and treatment. As a general rule, ultrasound is the primary examination method for obstetric and gynecological diseases, and UAVM is mainly diagnosed through ultrasound findings for further confirmation. Therefore, this study reviewed 121 cases of UAVM diagnosed by ultrasound at Tongji Hospital of Huazhong University of Science and Technology over the past 15 years to clarify the clinical incidence of UAVM diagnosed by ultrasound. Further review of the clinical data revealed that among the 121 patients diagnosed with UAVM by ultrasound, 19 cases presented with obvious clinical symptoms and were clinically diagnosed as UAVM. Then we conducted a classified discussion of these cases and provided a systematic description of UAVM. This study aims to provide clinical references for UAVM in various clinical situations through a more detailed classification method, thereby avoiding life-threatening bleeding, protecting fertility, and offering personalized treatment.