Postpartum Pseudoaneurysm After Cesarean Delivery

Abstract

Uterine artery pseudoaneurysm is an uncommon vascular lesion that can be life threatening. A ruptured uterine artery pseudoaneurysm can cause acute massive hemorrhaging, creating a true emergency for the postpartum patient. The etiology is more commonly seen with traumatic procedures such as cesarean delivery or curettage. This case report is of a patient with a history of HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome who presented with heavy bleeding after a cesarean delivery. Sonography was primarily used to diagnose the uterine artery pseudoaneurysm. Because of the massive hemorrhaging in this case, a hysterectomy was performed.

Uterine Artery Pseudoaneurysm: A Case Report

“…Digiacinto et al 12 concluded that follow-up CT is used to confirm the diagnosis identified on the sonogram. They stated that while CT is useful in identifying and diagnosing UAP, percutaneous angiography is considered the gold standard to diagnose a pseudoaneurysm and plays a role in the treatment as well.…”

“…Some authors have shown that clinical treatments of UAP include transcatheter arterial embolization, uterine artery ligation, ultrasound-guided thrombin injection, and hysterectomy. 12 Kwon et al 13 mentioned that uterine artery embolization (UAE) using N-butyl-2-cyanoacrylate is safe and effective in patients with PPH who show evidence of extravasation or pseudoaneurysm. The current patient was treated with UAE; 4-A transfemoral with 2-F microcatheter selective angiographic catheters were used to perform the procedure.…”