Uterine artery pseudoaneurysm in pregnant women with previous pelvic endometriosis

Brtnicky, Tomas; Chmel, Roman; Nováčková, Marta; Pavlík, Radim; Chmel, Roman

doi:10.23736/s2724-606x.21.04834-x

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…A uterine artery pseudoaneurysm (UAP) is primarily caused by injury to the uterine artery wall after a cesarean section, abortion, cervical conization, endometriosis, or myomectomy [1][2][3][4]. In true aneurysms, all three layers of the arterial wall form a bulge; in pseudoaneurysms, one or more layers of the arterial wall have a defect that forms a sac that communicates with the arterial lumen and is more likely to rupture than a true aneurysm.…”

Section: Introductionmentioning

confidence: 99%

A Case of Ruptured Exophytic Uterine Artery Pseudoaneurysm without Specific Risk Factors That Manifested Seven Days after Vaginal Delivery

Toshimitsu,

Iriyama,

Sato

et al. 2023

Case Reports in Obstetrics and Gynecology

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A uterine artery pseudoaneurysm (UAP) is a life-threatening complication during pregnancy and postpartum. Early diagnosis of exophytic UAP rupture is difficult due to the absence of vaginal bleeding. This study reports the case of a 31-year-old postpartum woman who presented with abdominal pain and fever seven days after vaginal delivery, without symptoms of maternal shock. Ultrasonography revealed a ruptured exophytic UAP with hemoperitoneum, which was confirmed using computed tomography. Interventional radiology confirmed that the site of the pseudoaneurysm was at the level of the uterine artery bifurcation, and embolization was performed immediately after diagnosis using a coil and n-butyl-2-cyanoacrylate. The patient’s symptoms were relieved, and she was discharged 12 days after the embolization. At eight months postpartum, the UAP was not visible on transvaginal ultrasonography. Exophytic UAP can occur even in the absence of specific risk factors such as cesarean section or endometriosis, and the UAP may not necessarily rupture immediately after delivery. Obstetricians must remain aware of the possibility of exophytic UAP rupture manifesting as abdominal pain with postpartum fever, rather than as unstable vital signs. This is the first report of an exophytic UAP that occurred at the level of the uterine artery bifurcation. Identification of the sites where exophytic UAP can occur can aid in the early diagnosis of the condition.

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Section: Introductionmentioning

confidence: 99%