Uterine Artery Pseudoaneurysm Research Articles

Acquired uterine artery pseudoaneurysm: a rare iatrogenic complication following cesarean delivery at complete cervical dilatation.

Acquired uterine artery pseudoaneurysm: a rare iatrogenic complication following cesarean delivery at complete cervical dilatation.

Uterine artery pseudoaneurysm presenting with subcutaneous hematoma and vaginal bleeding following cesarean delivery

We present a rare case of uterine artery pseudoaneurysm (UAP) following an emergency cesarean section, which led to severe vaginal bleeding and subcutaneous hematoma. The patient, a 40-year-old woman with no history of hemophilia or hemostasis disorders, presented with sudden profuse vaginal bleeding and multiple subcutaneous hematomas at the site of the cesarean scar ten days postoperation. Ultrasound and CT scan confirmed the presence of a pseudoaneurysm in the right uterine artery. Due to the unavailability of radiological embolization, surgical ligation of the right internal iliac artery was performed. Postoperative follow-up showed successful resolution of the pseudoaneurysm and cessation of bleeding. This case highlights the importance of considering UAP in the differential diagnosis of postpartum hemorrhage and demonstrates the efficacy of surgical intervention when embolization is not available.

Uterine Artery Pseudoaneurysm After Cesarean Section: A Rare Cause of Delayed Postpartum Hemorrhage

Uterine Artery Pseudoaneurysm After Cesarean Section: A Rare Cause of Delayed Postpartum Hemorrhage

Delayed Postpartum Hemorrhage Resulting from Uterine Artery Pseudo Aneurysm after Cesarean Section: A Case Report and Literature Review

Delayed Postpartum Hemorrhage Resulting from Uterine Artery Pseudo Aneurysm after Cesarean Section: A Case Report and Literature Review

EP25.22: A case of unruptured uterine artery pseudoaneurysm with embolisation after spontaneous vaginal delivery depicted using superb microvascular imaging

EP25.22: A case of unruptured uterine artery pseudoaneurysm with embolisation after spontaneous vaginal delivery depicted using superb microvascular imaging

Uncommon Presentation of Uterine Artery Pseudoaneurysm: A Case Report of Post Cesarean Hemorrhage

Uncommon Presentation of Uterine Artery Pseudoaneurysm: A Case Report of Post Cesarean Hemorrhage

Uterine Artery Pseudoaneurysm after Total Abdominal Hysterectomy Managed by Ultrasound-guided Percutaneous Glue Injection

Abstract Uterine artery pseudoaneurysm (UAP) following abdominal hysterectomy is an uncommon complication. However, it can cause life-threatening bleeding, necessitating early diagnosis and intervention. Imaging is vital in its prompt diagnosis and aids in planning interventions. Here, we describe a case of recurrent massive per-vaginal bleeding from a left UAP developed following total abdominal hysterectomy and bilateral salpingo-oophorectomy. Bleeding was successfully managed with percutaneous ultrasound-guided glue (N-butyl cyanoacrylate) injection into the aneurysmal sac. The patient is doing well without any recurrent bleeding.

2 Case Reports of Uterine Artery Pseudoaneurysm Diagnosed in Pregnancy and Postpartum – Successfully Embolised

Pseudoaneurysm is an extraluminal collection of blood with a turbulent flow that communicates with flowing arterial blood through a defect in the arterial wall. Uterine artery pseudoaneurysm (UAP) is considered a rare case that occurs in 2–3/1,000 deliveries. Here we discuss 2 cases – first case is UAP diagnosed antenatally in a woman with acute abdomen and hydronephrosis, second case presented as secondary delayed postpartum haemorrhage. Sonography revealed UAP, and the diagnosis was confirmed by angiography. The defects were. treated by uterine artery embolization. UAE is to be considered a life-saving procedure obviating need for hysterectomy and improves maternal outcome.

Embolization of uterine artery pseudoaneurysm during pregnancy: case report and review of the literature

Abstract Objectives Uterine artery pseudoaneurysm (UAP) is a rare but sinister complication during pregnancy. Diagnosis can be made by color Doppler ultrasound. Previous abdominal- and obstetric surgery increase the risk for UAP formation. Case presentation We present a case of a 36 year young healthy women, presenting at 27 weeks of gestation with acute lower abdominal pain. UAP was detected by color Doppler ultrasound. An endovascular coil embolization was performed, with good maternal and fetal outcome. Furthermore, a review of the literature looking at UAP embolization in pregnancy was performed. Conclusions UAP is reported to appear as a complication of endometriosis. UAP should be treated by endovascular coil embolization, which is a safe and with almost 100% success rate an effective treatment during pregnancy.

Saving The Uterus; Our Experience In Uterine Artery Embolization For Acquired Uterine Vascular Abnormalities.

Acquired uterine vascular abnormalities are a rare cause of potentially life threatening bleeding. These include uterine artery pseudoaneurysms (UAP)and acquired arteriovenous malformations. The objective of this study was to describe our experience with the diagnosis of acquired uterine vascular abnormalities and its treatment with uterine preservation. It was a retrospective cohort study. Eight patients were enrolled from the hospital database who presented to our Interventional Radiology department from April 2017 to March 2021 for uterine artery embolisation (UAE) with a history of iatrogenic/acquired uterine vascular abnormalities confirmed on imaging. These included two patients with uterine artery pseudoaneurysm (PA) concurrently with arteriovenous malformation (AVM), one with uterine artery PA and five having uterine AVMs. Embolisation agents used were histoacryl glue, lipiodol, PVA particles, and gelfoam slurry. Medical records, imaging studies, and telephonic contact with patients were assessed for patient presentation, intraprocedural details, and follow up to record treatment success. Statistical analysis was performed using descriptive statistics. Bilateral UAE was performed in six patients, while two patients underwent unilateral UAE. Three of the patients presented with life-threatening bleeds requiring multiple transfusions. Clinical as well as angiographic success was achieved in all patients with immediate control of haemorrhage. No complications were observed during follow-up. Two of the patients were able to conceive normally within one year, though it resulted in a miscarriage. Acquired/iatrogenic uterine vascular abnormalities are a rare but important cause of life-threatening haemorrhage that can be expertly managed and successfully treated using UAE, which is rapid, safe, and minimally invasive, with the added advantage fertility preservation.

Imaging in Uterine Artery Pseudoaneurysm: A Rare, Potentially Fatal Cause of Secondary Post-partum Hemorrhage

Secondary postpartum hemorrhage is one of the important cause of postpartum morbidity and mortality. Uterine artery pseudoaneurysm is a rare, potentially fatal but treatable cause of secondary post-partum hemorrhage. If not diagnosed timely, it can lead to life-threatening hemorrhage. We report the case of a 41-year-old woman who presented with profuse vaginal bleeding on 32nd day of cesarean section. On imaging a left uterine artery pseudoaneurysm was found in the uterine wall with blood clots in the uterine cavity. Patient was managed with aggressive fluid resuscitation and immediate interventional radiology procedure of selective embolization of pseudoaneurysm. High index of suspicion is needed to search for rare vascular causes like pseudoaneurysm.

Unilateral Uterine Artery Embolization Therapy For Secondary Postpartum Hemorrhage In Pseudoaneurysma Of The Sinistra Uterinary Artery Post-Cesarean Section

Introduction: Uterine artery pseudoaneurysm is one of the rare malformations of uterine blood vessels due to incomplete closure of the torn uterine artery wall. This condition accounts for about 3% of postpartum hemorrhage cases that could be life-threatening. Transcatheter arterial embolization has recently emerged as a safe and highly effective alternative treatment. Case Presentation: A 30-year-old woman complained of abdominal pain accompanied by a large amount of blood from the birth canal, which was felt on the 28th day after a cesarean section. The patient underwent laparotomy and had grade III intra-abdominal adhesions. On CT-Angiography investigation, we found saccular type aneurysm in the left uterine artery, hematometra, and fluid collection on the right side of the periuterine, multiple paraaortic lymphadenopathies, hepatomegaly, and left adnexal cyst. With the pseudoaneurysm, the patient was planned to undergo uterine artery embolization. The patient was discarded. During follow-up, results of CT-scan pelvic angiography include dilated and convoluted right uterine artery. Conclusion: In this case report, uterine artery embolization (UAE) was performed; this procedure was chosen because the effectiveness of embolization was 97% and could maintain the desire for future pregnancies. The fertility prognosis in this case report was quite good after unilateral uterine artery embolization was performed concerning regular menstrual cycles.

Endovascular Embolisation Using N-Butyl-2-Cyanoacrylate: An Effective Treatment Option for Uterine Artery Pseudoaneurysm in Postpartum Hemorrhage

AbstractIn this case series, we evaluated the efficacy and safety of uterine artery embolization (UAE) using N-butyl- 2-cyanoacrylate (NBCA)/glue for the treatment of uterine artery pseudoaneurysm (UAP). Here, we report 8 patients with uterine artery pseudoaneurysm, who underwent UAE using NBCA/glue. Angiograms and medical records were retrospectively analyzed to determine the technical success, clinical success, complications, average procedure time, the average duration of hospital stay after UAE. All patients were presented with secondary postpartum hemorrhage with hemodynamic instability. The technical and clinical success rates were 100%, respectively. The average procedure time was 21minutes and the average duration of hospital stay was 2.2 days. We did not encounter any major complications. Two patients following UAE were naturally conceived and delivered by repeat LSCS. UAE using NBCA/glue is a safe and effective treatment option for UAP in both hemodynamically stable and unstable patients.

Pelvic ultrasonography of the postpartum uterus in patients presenting to the emergency room with vaginal bleeding and pelvic pain.

Pelvic pain and vaginal bleeding are common symptoms in postpartum women presenting to the emergency room (ER). Pelvic ultrasonography plays a crucial role in evaluating symptomatic postpartum patients by allowing a rapid diagnosis and treatment initiation. The main goal of imaging is to distinguish between causes of pelvic pain and vaginal bleeding that may be managed conservatively and those requiring emergent intervention. This pictural essay focuses on the ultrasonographic features of common postpartum conditions for which patients may present to the ER with vaginal bleeding and pelvic pain, including retained products of conception, endometritis, uterine arteriovenous malformation, uterine artery pseudoaneurysm, ovarian vein thrombosis, bladder flap hematoma, and uterine dehiscence/rupture.

Uterine Artery Pseudoaneurysm after Cesarean Section Treated with Superselective Embolization: A Case Repor

Uterine Artery Pseudoaneurysm after Cesarean Section Treated with Superselective Embolization: A Case Repor

Role of Ovarian Artery to Uterine Artery Anastomosis in Uterine Artery Embolisation: A Retrospective Study

Introduction: Uterine Artery Embolisation (UAE) is now extensively recognised as a treatment for uterine fibroids, uterine artery pseudoaneurysms, and Uterine Arterio-Venous Malformations. The occurrence of collateral circulation from the ovarian artery to the uterine artery is one of the reasons for the failure of the process. The occurrence of ovarian failure and premature menopause after the UAE is high in patients with Utero-ovarian Artery (UOA) anastomosis. Aim: To classify UOA as per Razavi MK et al., angiographic classification and to determine the presence of such anastomosis in UAE procedure failure cases. Materials and Methods: A retrospective study was done for a period of two years from November 2017 to October 2019. UAE was performed with Poly Vinyl Alcohol (PVA) microparticles (300 to 500 µm in size) followed by capping with a gelatin sponge in all 25 cases and coils were used in three cases. The presence or absence of UOA and four different types as per Razavi MK et al., angiographic classification were noted. Results: Among 25 cases who underwent UAE, 14 had UOA. The majority (six cases) were type Ib, five cases were type Ia, two cases were type II and one case was type III. The bilateral anastomosis was noted in one case with type Ia and Ib on either side. Eight cases with UOA had successful embolisation. The UAE was successful in 16 cases, and failed in nine cases. Among various causes for failure, six out of nine were due to UOA. Among six failure cases of UOA, two cases were Type Ia, two cases were Type Ib, one case was Type II and one case was Type III anastomosis. Conclusion: UOA is one of the major risk factors in the procedural failures of the UAE. Identification avoids non target ovarian embolisation.

Successful laparoscopic surgery for a uterine artery pseudoaneurysm that occurred after conservative treatment for an interstitial pregnancy

Successful laparoscopic surgery for a uterine artery pseudoaneurysm that occurred after conservative treatment for an interstitial pregnancy

Diagnosis and treatment of uterine artery pseudoaneurysm: Case series and literature review.

Background:Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening cause of hemorrhage. Nonetheless, its knowledge could be insufficient among obstetricians, gynecologists, and radiologists. We aimed to clarify the clinical characteristics, management, and outcomes of UAP.Methods:We retrospectively analyzed nine female patients diagnosed with UAP at our institute between 2013 and 2020.Results:Seven cases presented with a history of traumatic surgery including cesarean section, dilation and curettage, laparoscopic myomectomy, and cervical conization. Two cases occurred after spontaneous vaginal delivery and second-trimester pregnancy termination. The main symptom was heavy/massive/prolonged vaginal bleeding. All patients were first evaluated by color Doppler ultrasonography and three cases were confirmed by magnetic resonance imaging. Severn patients underwent transarterial embolization (TAE) of the uterine arteries, and two were managed conservatively. All patients had good outcomes.Conclusions:UAP can develop after traumatic pelvic operations and non-traumatic delivery/abortion. It may be more common than previously considered. The risk of rupture may be correlated with multiple factors other than the mass size. TAE of the uterine artery could be an effective management strategy for ruptured UAP. However, some cases can resolve spontaneously without TAE, suggesting that conservative management can be employed in some women.

A Rare Case of Multiple Uterine Artery Pseudoaneurysms after Hysteroscopic Myomectomy

A 33-year-old para 2 presented with heavy vaginal bleeding on postoperative day 4 after an uncomplicated hysteroscopic myomectomy of 2 posterior submucosal fibroids (3 cm, 1 cm). Her history was notable for a term cesarean delivery 5 years earlier, a hysteroscopic myomectomy 3 years earlier, and a vaginal breech delivery 1 year earlier. Her vital signs were stable and abdominal examination was unremarkable. Pelvic examination revealed 10 cc of pooled blood upon speculum insertion. The cervical os was closed without significant active bleeding.

Pseudoaneurysm of the uterine artery with presentation of haematuria; a rare case report.

IntroductionPseudoaneurysm of the uterine artery is a condition in which extra luminal collection of blood with a turbulent flow that communicates with flowing blood of uterine artery through a defect in its arterial wall. As per literature uterine artery pseudoaneurysm is a very rare condition and its incidence is 2–3/1000 deliveries. Clinical diagnosis is very challenging and in the index case haematuria was the presenting complaint which in fact is the extremely rare presenting complaint. Angioembolization is the ideal treatment modality for such a rare condition.Case presentationA 25-year old female presented in a shock state with history of massive haematuria two months after delivering a baby. She was resuscitated with fluid, blood and blood products. A computed tomography angiogram was done which showed a large pseudoaneurysm of the left uterine artery so consequently angioembolization was done with n-butyl cyanoacrylate (NBCA) and lipoid mixture. Serial assessment of biochemical and clinical parameters depicted improvement in the clinical status of the patient. She was doing well at 6 months of follow up.DiscussionA post-partum massive haematuria could be due to pseudo aneurysm of uterine artery. The presentation of haematuria may occur due to communication of aneurysm with urinary bladder and which further get ruptured. Aggressive resuscitation and angioembolization of the pseudoaneurysm is employed to treat such patients.ConclusionPseudoaneurysm of uterine artery is rare condition which may present as haematuria. Once clinical diagnosis is suspected it's better to first resuscitate and plan for angioembolization for better outcome.