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Case Report
Uterine artery pseudoaneurysm: A rare cause of delayed postpartum hemorrhage
1 Resident PGY2, Obstetrics and Gynecology, TriHealth Bethesda North Hospital, Cincinnati, Ohio, USA
2 Resident PGY3, Obstetrics and Gynecology, TriHealth Bethesda North Hospital, Cincinnati, Ohio, USA
3 Laborist Attending, Obstetrics and Gynecology, TriHealth Bethesda North Hospital, Cincinnati, Ohio, USA
Address correspondence to:
Morgan Wilhoite
DO, 13345 Princeton Lane, Pickerington, Ohio 43147,
USA
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Article ID: 100095Z08MW2021
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Wilhoite M, Parikh S, Holbert M. Uterine artery pseudoaneurysm: A rare cause of delayed postpartum hemorrhage. J Case Rep Images Obstet Gynecol 2021;7:100095Z08MW2021.ABSTRACT
Introduction: Uterine artery pseudoaneurysm (UAP) is a rare, life-threatening cause of secondary postpartum hemorrhage. The purpose of this case is to highlight the diagnosis and management of UAP, utility of imaging and uterine artery embolization, and the risk of infertility after fertility-sparing therapies.
Case Report: A 30-year-old G2P1011 presented with delayed postpartum hemorrhage after a cesarean section. Transvaginal ultrasonography (TVUS) illustrated a hypoechoic area with blood flow in a swirling pattern. Interventional radiology visualized a large right uterine artery pseudoaneurysm on angiography. A uterine artery embolization (UAE) was successfully performed with resolution of the patient’s symptoms.
Conclusion: Transvaginal ultrasonography is the diagnostic modality of choice when the cause of secondary postpartum hemorrhage is unclear. Uterine artery embolization can safely manage UAP without significant impact on conception or adverse obstetric outcomes.
Keywords: Embolization, Hemorrhage, Infertility, Pseudoaneurysm
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Acknowledgments
We would like to thank and acknowledge Dr. Samantha Mast, MD for reading the ultrasound report and reporting her suspicion for a pseudoaneurysm to the admitting team.
Author ContributionsMorgan Wilhoite - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Shivani Parikh - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Michael Holbert - Conception of the work, Design of the work, Analysis of data, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Morgan Wilhoite et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
