Pseudoaneurysm of the Uterine Artery After Cesarean Delivery

Abstract

Color Doppler ultrasonography and computed tomography were useful for the early diagnosis of uterine artery pseudoaneurysm. Primary transcatheter arterial embolization controlled bleeding without compromising reproductive potential.

A case of vulvar hematoma with rupture of pseudoaneurysm of pudendal artery

“…Sherer et al [6] described perineal sonography, which offers objective imaging assessment of the extent of vulvar hematoma at the bedside and negates the need for complex and more expensive imaging modalities. Butori et al [7] proposed that computed tomography should be used as the principal diagnostic imaging modality because it is more specific in diagnosing aneurysms. Additionally, magnetic resonance imaging can provide a more detailed mapping of the lesion and exclude any retroperitoneal involvement [8].…”

Embolization of iatrogenic uterine pseudoaneurysm

“…Due to the wide spectrum of clinical presentation, 4 5 6 7 8 the differential diagnosis of postpartum hemorrhage should always consider a UAP. 2 …”

“…Since the first case reported by Brown et al 11 in 1979, arterial uterine embolization has been successfully performed to control postpartum bleeding caused by atony of the uterus, placenta accreta, extrauterine pregnancy, vulvar and vaginal hematomas, and UAP. The safety and effectiveness of selective uterine artery embolization were demonstrated by many reports 1 2 3 4 5 6 7 8 9 10 11 ; procedural complications are rare and include pelvic organ ischemia, sciatic and perineal nerve neuropathy, muscle pain, and postembolization syndrome. 12 …”

“… 4 5 As previously stated, a UAP may be either asymptomatic or present with symptoms such as vaginal bleeding, abdominal pain, hypovolemic shock, or fever when infected. 4 5 6 7 Such a vast array of symptoms can make it difficult to diagnose a UAP, especially in case of a nontraumatic delivery, abortion, or pregnancy termination. 8 The wide spectrum of symptoms associated with a UAP that mimic other conditions makes it a “chameleon” pathology; as a result, UAPs should always be considered in differential diagnoses.…”

Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

“…Color and pulsed Doppler ultrasonography may reveal a characteristic to-and-fro pattern, and it has been reported to have a diagnostic sensitivity of 95% [10, 11]. Computed tomography and magnetic resonance imaging can confirm the diagnosis and help rule out other more common causes of delayed postpartum hemorrhage.…”