Uterine perforation associated with gestational trophoblastic disease and arteriovenous malformation: A case report

• Published in: Case reports in women's health 2024-03, Vol.41, p.e00579, Article e00579
• Main Authors: Fisher, Lauren, Bahabri, Amin, Clare, Anna, Shakeri, Babak
• Format: Article
• Language: English
• Subjects: Arteriovenous malformation; Gestational trophoblastic disease; Gestational trophoblastic neoplasm; Uterine perforation
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2023.e00579

This case report outlines the clinical course of a young woman who presented as haemodynamically unstable due to uterine perforation. She had undergone suction dilation and curettage three weeks prior and received a diagnosis of complete molar pregnancy. During her most recent acute presentation, an emergency laparotomy revealed a full-thickness fundal uterine rupture in a region of newly identified arteriovenous malformation. Haemostasis was achieved with the primary repair of the perforation. She was subsequently diagnosed with gestational trophoblastic neoplasm (GTN), a condition characterised by abnormal proliferation of trophoblastic tissue. She received three courses of methotrexate followed by a two-month course of dactinomycin. At one-year surveillance, she had made a complete recovery. •Uterine perforation following diagnosis of gestational trophoblastic disease.•Emergency laparotomy revealed a full-thickness fundal uterine rupture adjacent to a region of arteriovenous malformation.•Primary repair of the perforation, with preservation of fertility.•Gestational trophoblastic neoplasm was diagnosed after 10% BHCG rise occured within two weeks of the laparotomy.•Three courses of methotrexate, followed by a two-month course of dactinomycin before returning to a negative BHCG.