AVOID HYSTERECTOMY WITH DAY CARE KEY HOLE ENDO-VASCULAR SURGERY

TRUE INCIDENT

28 year old mother of 3 year old girl.
Had a miscarriage 3 months ago, treated with D&C (Dilatation and Curettage).
Presented to emergency with severe PV bleeding and drop in haemoglobin by 4 units.
Ultrasound scanning diagnoses acquired arteriovenous malformation( Abnormal vessels developed due to prior miscarriage and its treatment)

WHATS THE TREATMENT ?
Beyond Surgery
1.Emergency hysterectomy was contemplated.
2.But she want to retain her uterus for second child.
3.Any thing apart from Surgical removal of uterus?

LEFT INTERNAL ILIAC ARTERY ANGIOGRAM
HYPERTROPHIED UTERINE ARTERY WITH ABNORMAL BLUSH ( LEAKAGE)

POST EMBOLISATION
NO RESIDUAL BLUSH AND THUS STOPPED BLEEDING