Uterine Pseudoaneurysm Research Articles

Secondary postpartum hemorrhage: Incidence, etiologies, and clinical courses in the setting of a high cesarean delivery rate.

To evaluate the incidence, etiologies, and clinical outcomes of secondary postpartum hemorrhage in a hospital with a high cesarean section rate and to compare the etiologies of secondary postpartum hemorrhage following cesarean delivery versus vaginal delivery. This retrospective study included 123 women with secondary postpartum hemorrhage who were treated at a tertiary-level hospital between January 2004 and June 2018. Descriptive statistics and the chi-square test were used for data analysis. The incidence of secondary postpartum hemorrhage was 0.21%. The median onset of bleeding was 12 days after delivery. Fifty-two percent of the deliveries were by cesarean section. The most common etiology of secondary postpartum hemorrhage was endometritis (67.5%), followed by retained placental tissue (21.1%). Women who delivered by cesarean section had a higher rate of endometritis (80.0% vs 53.4%) and a lower rate of retained placental tissue (10.8% vs. 32.8%) than those who delivered vaginally. Surgical intervention included uterine evacuation in 29.3% and hysterectomy in 8.1% of the patients. Five percent of women were treated by embolization. Endometritis was the most common cause of secondary postpartum hemorrhage. Women who delivered by cesarean section were less likely to have retained placental tissue but were at higher risk for endometritis and uterine pseudoaneurysm than those who delivered vaginally.

Uterine pseudoaneurysm on the basis of deep infiltrating endometriosis during pregnancy-a case report

BackgroundPseudoaneurysm of the uterine artery (UPA) is a rare cause of potentially life-threatening hemorrhage during pregnancy and puerperium. It is an uncommon condition that mainly occurs after traumatic injury to a vessel following pelvic surgical intervention, but also has been reported based on underlying endometriosis. There is an increased risk of developing UPA during pregnancy. Diagnosis includes clinical symptoms, with severe abdominal pain and is confirmed by sonographic or magnetic resonance imaging (MRI). Due to its potential risk of rupture, with a subsequent hypovolemic maternal shock and high fetal mortality, an interdisciplinary treatment should be considered expeditiously.Case presentationWe present the case of a 34-year old pregnant symptomatic patient, where a large UPA was detected at 26 weeks, based on deep infiltrating endometriosis (DIE). The UPA was successfully treated by selective arterial embolization. After embolization, the pain decreased but the woman still required intravenous analgesics during follow-up. At 37 weeks she developed a sepsis from the intravenous catheter which led to a cesarean section and delivery of a healthy boy. She was discharged 10 days postpartum.ConclusionsUPA should be considered in pregnant women with severe abdominal and pelvic pain, once other obstetrical factors have been excluded. DIE might be the underlying diagnosis. It is a rare but potentially life-threatening condition for mother and fetus.

Secondary postpartum hemorrhage due to uterine artery pseudoaneurysm

We present the case of a 26-year-old female who experienced secondary postpartum hemorrhage nine days after an uncomplicated elective repeat low transverse cesarean section. She was found to have a uterine pseudoaneurysm and underwent gel foam embolization of the right uterine artery. Subsequently, patient was diagnosed with pulmonary embolism on post-embolization day 3, and was initiated on anti-coagulation regimen.

A case of uterine pseudoaneurysm occured outside of the uterus that presented with hydronephrosis after spontaneous vaginal delivery

A case of uterine pseudoaneurysm occured outside of the uterus that presented with hydronephrosis after spontaneous vaginal delivery

Long-term uterine balloon tamponade for treatment and obliteration of ruptured uterine pseudoaneurysm

ObjectiveRupture of uterine artery pseudoaneurysm (UAP) is a life-threatening event after childbirth. Hysterectomy or uterine arterial embolization was often needed for hemostasis. However, such procedures may cause severe morbidities for these women. To estimate the efficacy of uterine balloon tamponade (UBT) for controlling ruptured UAP bleeding, a retrospective analysis in a single teaching hospital was performed. Materials and methodsWe reviewed the medical record of Juntendo University Hospital in 2015. All the women diagnosed with UAP were recruited to this study and management for UAP was investigated. ResultsThree women were treated with UBT for ruptured UAP. All cases achieved hemostasis. One case had recurrent UAP after 24 h of UBT, and was retreated with UBT for a longer duration. The UAP was obliterated after more than 2 days of UBT in all cases. ConclusionUBT has potential as a therapeutic technique not only for treatment of a ruptured UAP but also for obliteration of a UAP.

Efficacy of computed tomography for the diagnosis of postpartum hemorrhage

The authors evaluated the diagnosis of the cause of post-partum haemorrhage (PPH) by computed tomography (CT). They retrospectively transferred 15 patients with PPH from local clinics between January 2010 and December 2011. CT revealed diverse causes. Only two cases had no additional finding on CT. They found deep tearing extending to the lower uterine segment and uterine artery in two cases, whereas five cases were an arteriovenous malformation, and one case was a uterine pseudoaneurysm.

Uterine Artery Pseudoaneurysm Mimicking Adnexal Mass

Abstract Background: A uterine pseudoaneurysm is an extremely rare arterial wall defect with life-threatening complications such as retroperitoneal hemorrhage. Case: A case of uterine artery pseudoaneurysm in a 38-year-old woman with menorrhagia, and its surgical management, are reported. Results: Exploratory laparotomy was performed. The pseudoaneurysm was identified, ligated, and excised, followed by total abdominal hysterectomy with bilateral salpingo-oophorectomy. The patient's postoperative course was uneventful. Conclusions: Despite arterial embolization being an effective and safe treatment, individual circumstances can change the management of uterine pseudoaneurysms. (J GYNECOL SURG 29:336)

Uterine pseudoaneurysm leakage may cause delayed postpartum haemorrhage: Multidetector CT with angiography and transcatheter uterine arterial embolisation

The aim of this retrospective case study was to evaluate the role of transcatheter arterial embolisation in the management of delayed postpartum haemorrhage due to pseudoaneurysm leakage, and present the angiographic findings with multidetector computed tomography (CT) along angiography as a diagnostic tool. Delayed postpartum haemorrhage due to pseudoaneurysm leakage was diagnosed in eight patients at our institution between October 2006 and June 2010. The mean patient age was 31.0 years and the mean parity, 2.0. Bilateral uterine arterial embolisation was performed in all patients. No additional embolisation sessions or hysterectomies were performed. Multidetector computed tomography with angiography helped to demonstrate the location and originating vessels of the pseudoaneurysm via fast and clear 3D images. Transcatheter uterine arterial embolisation is an option in haemodynamically stable patients, and it appears to be the treatment of choice.

A case of uterine pseudoaneurysm combined with gestational trophoblastic disease in a 30-year-old woman

Uterine artery pseudoaneurysm is a rare disease and it can be diagnosed using conventional doppler ultrasongraphy. Damaged uterine arteries from cesarean section, myomectomy, dilatation & curettage, etc. are known as causes of the disease. Massive bleeding in the rupture can cause fatal result. We observed an increase in β-hCG and uterine artery pseudoaneurysm a year after the performance of dilatation & curettage for hydatidiform mole and treated it with arterial embolization and chemotherapy. We report the case and give a brief review of the literature.

Pseudoaneurysm of the uterine artery after laparoscopic myomectomy

To describe a case of uterine pseudoaneurysm after laparoscopic myomectomy in a 36-year-old woman. Case report. University hospital. A 36-year-old woman, 3 months after laparoscopic myomectomy, presenting with an intrauterine hypoechoic lesion measuring 5 cm in diameter. Uterine pseudoaneurysm was diagnosed by color Doppler ultrasound. Complete resolution of the pseudoaneurysm. Spontaneous thrombosis was observed in the pseudoaneurysm. At 6-month follow-up, the uterus appeared normal. Our case presents the possibility of delayed occurrence of uterine pseudoaneurysm after laparoscopic myomectomy.

Iatrogenic secondary post‐partum haemorrhage: Apropos of two uncommon cases

In this article we would like to highlight uterine pseudoaneurysm as a cause of secondary post-partum haemorrhage following Caesarean section. We would like to stress Doppler ultrasound scan as the initial screening modality for this condition. We also describe angioembolization as the prudent treatment option for this condition rather than resorting to surgery.