Pulmonary arteriovenous malformations
Pulmonary arteriovenous malformations (PAVMs) are most commonly seen in association with Osler-Weber-Rendu syndrome—hereditary haemorrhagic telangiectasia. This is an autosomal dominant vascular dysplasia characterized by epistaxis, mucocutaneous telangiectasias, and arteriovenous malformations in the brain, lung, liver, gastrointestinal tract, or spine.
The risks included bleeding leading to potentially catastrophic haemoptysis, infectious and ischaemic neurological manifestations due to paradoxical emboli, and high-output cardiac failure due to systemic arteriovenous shunting.Those with PAVMs that bleed in pregnancy should be treated as outside pregnancy with coiling of the PAVMs using interventional radiology. Women should therefore deliver in facilities with interventional radiology support.
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