Uterine artery pseudoaneurysm with an anastomotic feeding vessel requiring repeat embolisation

Abstract

Uterine artery pseudoaneurysm (UAP) is a rare cause of delayed postpartum haemorrhage. Early diagnosis and endovascular management are effective in treating this condition. We present the case of a 36-year-old gravida 3, para 2 woman with delayed postpartum haemorrhage and endometritis following a spontaneous vaginal delivery. Ultrasound and catheter angiogram demonstrated a UAP arising from the distal aspect of the left uterine artery. Significant bleed persisted despite selective bilateral uterine artery embolisation. A repeat angiogram confirmed complete occlusion of bilateral uterine arteries, but abdominal aortogram demonstrated that the left ovarian artery was now feeding the pseudoaneurysm. A repeat embolisation procedure was performed to occlude the left ovarian artery. The patient was discharged the following day. Selective arterial embolisation is effective in the management of UAP. Persistent bleeding despite embolisation should raise the suspicion of anastomotic vascular supply and may require repeat embolisation.

Spontaneous Rupture of a Right Gonadal Artery Aneurysm: A Case Report

“…Gonadal artery aneurysm is a relatively rare condition that can be life-threatening if left untreated. In the last 20 years, less than 30 cases of this condition have been reported [1][2][3][4][5][6]. Most cases are related to pregnancy or premenopausal peripartum period, although cases occurring during postmenopausal have also been documented [7].…”

Post embolization complications in a case of uterine artery pseudoaneurysm

“…Uterine artery pseudoaneurysm is a rare cause of delayed postpartum hemorrhage. Early diagnosis and endovascular management are effective in treating this condition [7,8].…”

Uterine Artery Pseudoaneurysm after an Uncomplicated Vaginal Delivery: A Case Report

“…UAPs mainly occur after traumatic delivery, including caesarean section or surgical procedures such as hysterectomy, myomectomy, curettage or conization. It can be a rare cause of delayed postpartum hemorrhage, and occurs in approximately in 2–3/1000 births [ 1 , 2 ].…”