Uterine artery aneurysm rupture in pregnancy

Cardia, Giuseppe; Loverro, Giuseppe; Nappi, E.; Strada, L.; Selvaggi, L.

doi:10.3109/01443619409004067

Cited by 5 publications

(7 citation statements)

References 1 publication

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“…Only during surgery can the real cause be identified because there are no premonitory signs and symptoms that would suggest, especially during an end-term pregnancy, the possibility of an arterial dystrophy of the iliac-pelvic region. The aneurysmal dilatations that occur in these cases do not reach large dimensions before rupture, as shown in a case reported by one of the authors, 4 in which only autopsy has been definitive (Fig. 3).…”

Section: Discussionmentioning

confidence: 53%

“…The most common aneurysmal diseases during pregnancy are aortic dissection and cerebral and splenic artery aneurysms; renal, coronary, iliac, and utero-ovarian aneurysms have also been reported but are fewer in number. 4,10 With regard to the iliac-hypogastric arterial region, which is closest to the specific organs of pregnancy, it is important to point out that isolated iliac aneurysms are absolutely rare, constituting only 1 to 2% of all abdominal aneurysms, and affect especially the elderly. 11 Many agree that these isolated iliac aneurysms have a risk of rupture at least equal to that of abdominal aorta aneurysms, and the two often coexist, creating further technical difficulties for treatment.…”

Section: Discussionmentioning

confidence: 99%

“…14 Rare aneurysmal lesions have also been found in the ovarian and uterine arteries; almost all of these lesions were detected in patients who had a rupture during pregnancy or soon after it. 4,5,10,15 It has been underlined that these cases may have a certain relationship to the weakening of the arterial wall, for example, in the case of Marfan syndrome, Ehlers-Danlos IV disease, cystic necrosis of the tunica media, syphilis, and other contagious or autoimmune diseases.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of this disease is not completely known, but many believe it is multifactorial (e.g., mechanical, hormonal, and genetic factors). 1,2 Aneurysms of the aorta and of the cerebral, splenic, and renal artery have been reported; others such as coronary, 3 utero-ovarian, 4,5 and iliac aneurysms are very rare. 6 They are all characterized by lack of any symptoms until their dramatic appearance, determined by the rupture, especially in the third trimester In pregnancy and puerperium, vascular diseases may occur.…”

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confidence: 99%

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Unusual Pregnancy-Related Vascular Emergency

Cardia¹,

Iusco²,

Melino³

et al. 2002

Am J Perinatol

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Although rare, aneurysms are well-known pregnancy-related vascular diseases. They are influenced by hormonal, mechanical, and genetic factors and may be associated with high incidence of maternal and fetal mortality. We present a case of a pregnancy-related common iliac aneurysm, ruptured 5 days after delivery. The source of bleeding was recognized during the second emergency laparotomy for hemoperitoneum and retroperitoneal hematoma. The treatment consisted of excision and substitution of the common iliac artery (totally involved) by an autologous saphenous vein graft. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication that may occur during pregnancy or shortly after delivery.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Unusual Pregnancy-Related Vascular Emergency

Cardia¹,

Iusco²,

Melino³

et al. 2002

Am J Perinatol

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“…Our 2 cases of true UAA diagnosed during pregnancy highlight that although there is no common differential diagnosis for nonspecific pelvic and bladder symptoms, the condition can readily be diagnosed with color Doppler imaging in the antenatal period, thereby allowing for delivery by planned Caesarean sections and avoiding lifethreatening emergencies in labor to the mother and child [5][6][7] . UAA should be considered in the differential diagnosis in women with pelvic and vaginal masses, bladder symptoms, urethral obstruction or lower abdominal pain with radiation to the legs due to compression of nerve bundles.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of True Uterine Artery Aneurysms Diagnosed during Pregnancy

Schlütter

Johansen²,

Helmig³

et al. 2016

Gynecol Obstet Invest

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We report 2 cases of true uterine artery aneurysms diagnosed during pregnancy. Both cases presented with nonspecific symptoms such as urethral obstruction, minimal vaginal bleeding and lower abdominal pain in the 2nd trimester. Both aneurysms were diagnosed by color Doppler ultrasound. In the first case labor was induced at 37 + 4 weeks of gestation. However, due to sudden fetal distress and maternal abdominal pain, an emergency Caesarean section was performed during labor, and 3 liters of intra-peritoneal blood were encountered upon laparotomy, secondary to a ruptured uterine artery aneurysm. In the second case, an elective Caesarean section was scheduled at 38 + 3 weeks of gestation, and the delivery and postpartum period were uncomplicated. Albeit a rare condition, a uterine artery aneurysm should be among the differential diagnosis considered in pregnant women who present with pelvic and vaginal masses, vague bladder symptoms or radiating pelvic pain. The diagnosis is readily made by color Doppler imaging. Elective Caesarean section should be the preferred mode of delivery to avoid rupture of the aneurysm during labor.

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