International Journal of Health Sciences and Research DOI: https://doi.org/10.52403/ijhsr.20211116 Vol.11; Issue: 11; November 2021 Website: www.ijhsr.org Case Report ISSN: 2249-9571 International Journal of Health Sciences and Research (www.ijhsr.org) 130 Vol.11; Issue: 11; November 2021 Uterine Arterio-Venous Malformation: A Rare Post Mortem Finding in a Young Female Sumiti Gupta 1 , Renuka Verma 2 , Rajnish Kalra 3 , Sunita Singh 4 1,3 Professor, Pathology, 2 Assistant Professor, Pathology, 4 Senior Professor, Pathology, Department of Pathology, Pt. B.D. Sharma PGIMS, UHS, Rohtak, Haryana Corresponding Author: Renuka Verma ABSTRACT Uterine arterio-venous malformation is one of the differentials of dysfunctional uterine bleeding that can result in life-threatening emergency with sudden, unexpected massive vaginal bleeding. We describe a case of 20-year old female, who presented with sudden heavy vaginal bleeding and was diagnosed with uterine arterio-venous malformation on post-mortem examination. High index of suspicion is required to make a timely diagnosis for appropriate management and to avoid maternal morbidity and mortality. Keywords: Uterine arterio-venous malformations, embolization, dysfunctional uterine bleeding. INTRODUCTION Vascular lesions of the uterus are rare, among which arterio-venous malformations (AVMs) accounts for an approximate incidence of 4.5%. 1 AVMs are abnormal growth and connection between arteries and veins without an intervening capillary bed, resulting in areas of high and low flow, which are fragile and prone to bleeding. 2 Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of acquired vascular lesions following pregnancy, abortion, caesarean section, and curettage. 3 So, it should be kept as one of the possibility in a patient with massive vaginal bleeding, especially in the presence of hemodynamic instability. CASE REPORT A hysterectomy specimen was received from the dead body of 20years old female for histopathological examination. The deceased was married and presented in emergency department with sudden massive vaginal bleeding for last 6 hours. She gave history of light spotting from last 2 days preceding this sudden heavy bleeding. She also had irregular menses ever since a missed abortion 6 months prior. During this episode of sudden heavy vaginal bleeding, she also complained of suprapubic cramping, but no associated nausea, vomiting, dizziness, chest pain, or shortness of breath. On presentation, the patient’s vital signs showed a blood pressure of 90/60 mmHg, pulse of 120, respiratory rate of 28 and temperature of 99.7°F. Her urine pregnancy test was negative. She had normal external genitalia with no signs of trauma. Her vaginal examination revealed copious dark blood and clots, with no trauma noted. Her cervix had no lesions and clots were noted in the os. On bimanual examination, she had a closed cervical os, no cervical motion tenderness, and no adnexal tenderness. Her laboratory studies, including electrolyte panel, coagulation studies, and thyroid function tests were unremarkable. She had haemoglobin of 8.1 g/dL and