Uterine Arteriovenous Malformation: A Rare Cause of Secondary Postpartum Hemorrhage
Bibliographic record
Abstract
Ruptured uterine arteriovenous malformation (AVM) such as uterine artery pseudoaneurysm is an extremely rare cause of secondary postpartum hemorrhage (PPH), thus causing a diagnostic and therapeutic dilemma for the managing obstetricians. We describe a case of a 40-year-old lady who presented with recurrent intractable secondary PPH unresponsive to conventional treatment following an emergency lower segment cesarean section (LSCS). This was her second LSCS for a failed trial of vaginal birth after cesarean section (VBAC). Subsequently left uterine artery extravasation was identified on pelvic angiogram and selective embolization was done with successful treatment of her PPH. To date, there have been only case reports or case series available on literature due to its rarity of the diagnosis. We wish to raise awareness of this rare diagnosis in patients with risk factors as a cause of recurrent PPH not responding to medical management. We also wish to share our experience with the successful use of selective uterine artery embolization for the management of this condition which resulted in avoidance of hysterectomy and its associated morbidity. J Med Cases. 2017;8(5):152-154 doi: https://doi.org/10.14740/jmc2804w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".