Selective Uterine Artery Embolization: An Effective Treatment Option for Postpartum Hemorrhage due to Pseudoaneurysm of Uterine Artery

Abstract

Aim: To demonstrate the efficacy of uterine artery embolization in the management of postpartum hemorrhage (PPH) due to pseudoaneurysm of the uterine artery. Background: Postpartum hemorrhage is a leading cause of maternal mortality in India. Secondary PPH is a rare cause but potentially life threatening. Common causes of secondary PPH are retained products of conception, subinvolution of uterus, and endometritis. Pseudoaneurysm is an uncommon cause of secondary PPH following operative delivery. Color Doppler ultrasound is a useful diagnostic tool and angiography is necessary to localize and treat by embolization. Case report: We report two cases of secondary PPH due to pseudoaneurysm of uterine artery, which were managed by selective embolization of uterine artery. Conclusion: Angiographic embolization of uterine artery is a safe and reliable technique for management of secondary PPH due to pseudoaneurysm. If diagnosed early, the need for hysterectomy is prevented. Clinical significance: Uterine artery embolization has emerged as a simple, effective, and fertility-sparing treatment for PPH.