Acute pulmonary embolism in a patient with cesarean scar pregnancy after receiving uterine artery embolization: a case report

Abstract

Uterine artery embolization (UAE) is considered to be an effective treatment for patients with cesarean scar pregnancy, especially for those presenting uncontrollable hemorrhage. However, it can also cause some potential complications. Pulmonary embolism is a rare but fatal complication in patients treated with UAE. Here, we report a case of a woman who was diagnosed with cesarean scar pregnancy presenting with pulmonary embolism during the operation of dilation and curettage after UAE treatment. Prompt resuscitation was carried out and the patient received anticoagulant treatment immediately. During the follow-up, she recovered well without any complications. We present the clinical details and imaging findings, followed by discussions of the etiology, treatments, and prevention strategies.

Combined laparoscopic and hysteroscopic management of cesarean scar pregnancy with temporary occlusion of bilateral internal iliac arteries

“…Although there is no consensus on treatment, currently available treatments reported in the literature include medical therapy, uterine artery embolization (UAE) in combination with dilatation and curettage, hysteroscopic resection, laparotomic resection, laparoscopic resection, and transvaginal resection. Medical therapy involves long recovery times, whereas UAE has complications such as postthrombotic syndrome, injury to ovarian function and the urinary system, and even pulmonary embolism, [ 1 ] sepsis, [ 2 ] and rectal perforation. [ 3 ] Neither medical therapy nor UAE in combination with dilatation and curettage can repair scar dehiscence, and these treatments do not reduce the risk of recurrence, particularly for patients who wish to preserve fertility.…”

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“…8 Second, passage of embolization material such as gel foam directly into venous system can lead to pulmonary embolism. 9 Thirdly, during embolization procedure there can be inadvertent injury of endothelial cells, thus promoting local thrombosis and promoting coagulation. 10 Lastly, currently there is no standard regarding initiating anticoagulation after UAE.…”

Delayed diagnosis of a cesarean scar pregnancy: a case report

“…One of the serious complications of uterine artery embolization is pulmonary embolism. As pulmonary embolism is rare but life-threatening, obstetricians should be aware of the potential for serious complications after uterine artery embolization procedures and should evaluate the risk of embolization as a treatment option [22]. Also, because our patient has only one living child, we chose laparotomy instead of uterine artery embolization in this case.…”