Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation

Moatti, Zoe; Nisner, Tamar; Saini, Ashish; Karoshi, Mahantesh

doi:10.1136/bcr.05.2011.4270

Cited by 10 publications

(8 citation statements)

References 9 publications

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“…The wall of a pseudoaneurysm is particularly fragile as the three layers of a true aneurysm (tunica, media, and adventitia) are absent, and rupture can lead to catastrophic bleeding. Importantly, if delayed postpartum hemorrhage is overlooked and instead misdiagnosed as retained products of conception and a therapeutic curettage is performed, this can even worsen the bleeding 1,2 . Transabdominal and transvaginal ultrasound with color Doppler are diagnostic.…”

Section: Discussionmentioning

confidence: 99%

Pseudo aneurysm of the uterine artery with arteriovenous fistula after cesarean section: A rare but sinister cause of delayed postpartum hemorrhage

Pohlan

Hinkson

Wickmann

et al. 2020

J of Clinical Ultrasound

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Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosis and management may result in rapid and catastrophic postpartum hemorrhage and may necessitate hysterectomy or can even be fatal. A 28‐year‐old woman (gravida I, para I) presented with delayed postpartum hemorrhage 10 days after emergency cesarean section. Using transabdominal and transvaginal Color Doppler sonography, we detected a pseudoaneurysm in the posterior uterine wall, which was successfully treated with selective embolization distal and proximal to the lesion with platinum coils. In patients with delayed postpartum hemorrhage—especially after cesarean section—the rare possibility of uterine artery pseudoaneurysm must be kept in mind.

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Section: Discussionmentioning

confidence: 99%

Pseudo aneurysm of the uterine artery with arteriovenous fistula after cesarean section: A rare but sinister cause of delayed postpartum hemorrhage

Pohlan

Hinkson

Wickmann

et al. 2020

J of Clinical Ultrasound

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“…There have been other case reports of successful arterial embolisation 5 6. However, most cases of postpartum arterial rupture presented with vaginal bleeding and were followed by caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Delayed postpartum abdominal bleeding caused by a spontaneous ruptured branch of the internal iliac artery and successfully treated by arterial embolisation

et al. 2015

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A 34-year-old gravida 2 para 1 had an uneventful second pregnancy and successful vaginal birth after caesarean section. She was readmitted on the third day postpartum with severe abdominal pain coinciding with lactation. On admission, her vital signs were stable and was expectantly managed. After an unexpected drop in haemoglobin level, a CT scan was ordered, showing a haemoperitoneum. Laparoscopy was performed and 2.5L of blood was evacuated from the peritoneal cavity, no source of the bleeding could be identified. At the intensive care unit the patient's vital signs deteriorated and her haemoglobin level dropped to 2.2 mmol/L. The patient was stabilised and instead of a laparotomy to locate the bleeding, an arterial CT and angiography were performed. This revealed the presence of a blush from a pseudoaneurysm rising from a branch of the internal iliac artery. The artery was successfully occluded by embolisation.

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“…Compared with PPH due to retained products of conception and/or endometritis, the bleeding is usually painless and is not associated with pyrexia. Treatment is either "observation" hoping that natural healing process will put a limit to this condition or uterine artery embolization if the bleeding persists and intervention is required [10][11][12] .…”

Section: Figure 1: a Transverse Color Doppler Image Shows A Swirling mentioning

confidence: 99%

Postpartum Hemorrhage Caused by Pseudoaneurysm Associated with Malformations of the Uterus

Rajab¹,

Sibai²

2013

BMB

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Uterine vascular abnormalities and pseudoaneurysm are rare but could cause serious delayed postpartum hemorrhage. Bleeding is usually recurrent and may be severe and occasionally potentially life-threatening. We present the first diagnosed case reported from Bahrain. The patient was 23 years old, para 1, abortion 0, had recurrent postpartum hemorrhage following cesarean section caused by a traumatic pseudoaneurysm which was treated with hysterectomy. The treatment of choice is uterine artery embolization if diagnosed early and this method is particularly helpful to preserve the reproductive function in women.

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Delayed postpartum haemorrhage secondary to a ruptured uterine artery pseudo-aneurysm, successfully treated by transarterial embolisation

Cited by 10 publications

References 9 publications

Pseudo aneurysm of the uterine artery with arteriovenous fistula after cesarean section: A rare but sinister cause of delayed postpartum hemorrhage

Pseudo aneurysm of the uterine artery with arteriovenous fistula after cesarean section: A rare but sinister cause of delayed postpartum hemorrhage

Delayed postpartum abdominal bleeding caused by a spontaneous ruptured branch of the internal iliac artery and successfully treated by arterial embolisation

Postpartum Hemorrhage Caused by Pseudoaneurysm Associated with Malformations of the Uterus

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