Introduction/Background Uterine arteriovenous malformations (AVM) can cause life-threatening abdominal and vaginal bleeding in gestational trophoblastic neoplasia (GTN) in 1–2% of cases. This may interfere with fertility-sparing treatment.

Methodology From 1991 to 2021, angiography was used for diagnostic and therapeutic purposes in 60 GTN patients aged 19 to 51 years (average age 28 years). The majority of the cases were postmolar low-risk GTN (81.7%). Rare morphological variants of GTN were not observed. 50% of women were nulliparous. Clinically, AVMs manifested with vaginal bleeding of varying intensity.

One (right-sided) access was used for point-by-point catheterization of the right and left uterine arteries. Using transfemoral access, an F5 ’Cobra’ catheter was inserted using an F5 introducer. For embolization, 1 ml Bead Block microspheres 700–900 µm Terumo, Japan were used.

Results On angiograms, tumours appear very uniformly. The angiographic symptoms of malignant trophoblastic tumours are presented in table 1.

Most patients (96.7%) were treated conservatively, so the effectiveness of their treatment was monitored by ultrasound and hCG testing. Necrosis of the tumour parenchyma in 2 (3.3%) operated patients was 80% and 100% respectively. Two women (3.3%) with partial clinical effect underwent a repeat uterine artery embolization 14 days later. In 2 cured women (3.3%), uterine artery embolization was performed due to bleeding 1 year after treatment.

Conclusion - The combination of standard chemotherapy and uterine artery embolization in patients with GTN and arteriovenous malformations allows fertility-sparing treatment even in patients with large tumors localized in the uterine cervix.

- Uterine artery embolization does not compromise future pregnancy.

Disclosures Authors have no conflict of interest to declare.