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JG is a 25-year-old G2P0 female with one previous uneventful medical abortion in October
2008 and no live children. In December 2009, she was admitted to a hospital with a
first episode of severe vaginal bleeding. An arteriovenous malformation (AVM) was
suspected on a vaginal ultrasound and was confirmed by Doppler ultrasound and an MRI.
These studies demonstrated a dilated vessel arising from the left uterine artery,
reaching almost to the endometrial surface and ending as a cystic 15-mm formation
with demonstrable internal flow (Fig. 1, Fig. 2, Fig. 3). The hemorrhage stopped spontaneously and no treatment was initiated. She had a
second episode of bleeding in April which again stopped by itself. No transfusions
were needed but her hemoglobin dropped to 9 mg/mL each time. Apart from these two
episodes, her menses remained regular and normal in quantity.
