Delayed Postpartum Hemorrhage Resulting From Uterine Artery Pseudoaneurysm Rupture

Yun, Soon Young; Lee, Dong Hoon; Cho, Kwang Hyun; Lee, Hyung Min; Choi, Yoon Hee

doi:10.1016/j.jemermed.2011.03.005

Cited by 23 publications

(29 citation statements)

References 16 publications

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“…In a review, 32 cases were analyzed, and the size of the pseudoaneurysm was measured. The mean size of the pseudoaneurysms was 13±7 mm (mean±standard deviation), and most pseudoaneurysms were ≤20 mm (84%) [25678910111213]. Among the 32 described cases, 2 were diagnosed as intra-myometrial UAPs.…”

Section: Discussionmentioning

confidence: 99%

Delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture

et al. 2017

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A 30-year-old woman experienced severe abdominal pain 8 days after vaginal delivery. The patient was diagnosed with hemoperitoneum due to rupture of the left uterine artery pseudoaneurysm, which was confirmed via ultrasound with color Doppler and computed tomography scans. This patient was treated with bilateral uterine artery embolization to maintain fertility. A uterine artery pseudoaneurysm that causes delayed postpartum hemorrhage can occur after cesarean section or vaginal delivery. A uterine artery pseudoaneurysm can be fatal, so its detection and diagnosis are critical. Herein, we report a case of delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture.

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Section: Discussionmentioning

confidence: 99%

Delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture

et al. 2017

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“…Unlike a true aneurysm, this sac is contained by the surrounding soft tissue, rather than the artery's native three‐layered wall (intima, media, and adventitia). The continuous extra‐luminal blood flow can cause the sac to enlarge and rupture …”

Section: Discussionmentioning

confidence: 99%

“…Color Doppler US is the best initial screening exam, with a sensitivity and specificity around 95% . On gray‐scale, a pulsatile hypoechoic mass will be visible with a connection to its parent artery.…”

Section: Discussionmentioning

confidence: 99%

“…Initial treatment of PPH may consist of aggressive fluid and/or blood product resuscitation and tamponade (balloon, vaginal packings, Foley, etc.) in the emergency department . Although there are no clinical trials comparing the various pharmacologic, surgical, and endovascular interventions, more definitive treatment options include surgical ligation of the internal iliac or uterine artery, arterial embolization, or even extended bimanual ultrasound probe compression therapy .…”

Section: Discussionmentioning

confidence: 99%

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Novel approach to uterine artery pseudoaneurysm embolization for delayed post‐partum hemorrhage

Parker

Wuerdeman

Grant

et al. 2016

J of Obstet and Gynaecol

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Uterine artery pseudoaneurysms (UAP) are a rare cause of post-partum hemorrhage. Conservative management is discouraged due to the risk of spontaneous hemorrhage. Intra-arterial embolization is highly successful (>90%) and offers definitive treatment. We present the case of a 27-year-old woman with significant delayed post-partum hemorrhage after cesarean section who was found to have a UAP on imaging. Her tortuous vascular anatomy and spasmodic aneurysmal neck presented technical challenges to embolization with traditional material, such as gel foam and coils. Intra-arterial thrombin was then employed with good technical and clinical outcome. To our knowledge, this is the first case describing the use of intra-arterial thrombin in the treatment of UAP. Given its success in this case, we argue that intra-arterial thrombin should be considered a viable alternative for embolization of UAP when more traditional techniques fail.

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“…Early or primary postpartum hemorrhage occurs within the first 24 hours postpartum. The primary causes are uterine atony ( ∼ 70% of cases), retained placental fragments, endometritis, genital laceration, uterine inversion or rupture, and coagulation disorders [8]. Secondary postpartum hemorrhage is defined as excessive bleeding starting any time from 24 hours after delivery up to 6–12 weeks postpartum and most commonly occurs between 8 and 14 days postpartum [3].…”

Section: Discussionmentioning

confidence: 99%

Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

Yeniel

Ergenoğlu

Akdemir

et al. 2013

Case Reports in Obstetrics and Gynecology

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Uterine artery pseudoaneurysm is a rare but serious complication of cesarean section. If inadequately treated, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 28-year-old woman who developed secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm and cesarean scar dehiscence after cesarean section. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the surgical procedure of choice for hemodynamically unstable patients when fertility preservation is desired.

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Delayed Postpartum Hemorrhage Resulting From Uterine Artery Pseudoaneurysm Rupture

Cited by 23 publications

References 16 publications

Delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture

Delayed postpartum hemoperitoneum due to uterine artery pseudoaneurysm rupture

Novel approach to uterine artery pseudoaneurysm embolization for delayed post‐partum hemorrhage

Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

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