Peripartum hemorrhage: Two cases of ruptured ovarian artery aneurysms with additional multifocal intact aneurysms

Arleo, Timothy; Peters, Gail L.; Kokabi, Nima; Majdalany, Bill S.

doi:10.25259/jcis_145_2021

Cited by 1 publication

(1 citation statement)

References 11 publications

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“…Surgeons should consider that the ovarian and uterine arteries are established sources of hemorrhage in multiparous women presenting with unstable hemodynamics and retroperitoneal hematoma in their peripartum period [ 13 ]. By evacuating the hematoma and immediately ligating these arteries, such a patient may need no more invasive treatment, and experience less probability of thromboembolic complications.…”

Section: Discussionmentioning

confidence: 99%

Preventing thrombotic events in a case of postpartum ovarian artery aneurysm rupture: clinical challenges and management approaches

Rasti

Zarean

Jafarpisheh

et al. 2023

Journal of Surgical Case Reports

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Ovarian artery aneurysm is a rare asymptomatic condition usually diagnosed when it ruptures. It causes massive bleeding, often in the peripartum period of multiparous women, who are already at an increased risk for thromboembolic events. Balancing the bleeding risk against the thrombotic complications remains unexplored in such cases. A 35-year-old woman presented with hemorrhagic shock 3 days after delivering her seventh healthy child. During the emergent exploratory laparotomy, she responded well to the blood transfusion; the stable retroperitoneal hematoma indicated no need to explore it. A subsequent episode of hemodynamic instability necessitated another laparotomy, during which the hematoma was evacuated and both ovarian arteries were ligated. Shortly thereafter, the patient suffered a pulmonary embolism (PE). In multiparous patients presenting with peripartum retroperitoneal hematoma and hemorrhagic shock, exploring the hematoma and ligating the ovarian and uterine arteries may reduce the risk of PE or the need for reoperation.

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Section: Discussionmentioning

confidence: 99%