Korean J Obstet Gynecol.  2004 Nov;47(11):2236-2240.

An uncommon cause of postpartum hemorrhage after cesarean section treated with selective arterial embolization: Pseudoaneurysm of the uterine pedicle

• Kim MJ
• Park CH
• Kwen I
• Lee HJ
• Hur SY
• Kim EJ
• Lee GS
• Lee HG
• Kim SJ

Abstract

This is a very important differential diagnosis for postpartum hemorrhage following cesarean delivery because repeated life-threatening bleeding may induce multiple blood transfusion and require emergency surgery including hysterotomy. False or pseudoanuerysm can be acquired in association with trauma, previous surgery, trophoblastic disease, neoplasm, infection or diethylstilbestrol exposure. When a punctured or lacerated artery does not seal completely, blood may escape and dissects the adjacent tissues, and collects in perivascular areas. If this collection maintains in communication with the parent vessel, a pseudoaneurysm could result. Typically the lesion are discovered because the patients have symptoms related to delayed rupture of the pseudoaneurysms, causing hemorrhage. Radiographic techniques (angiography, ultrasound, and magnetic resonance imaging) have provided the opportunity to diagnose pseudoaneurysm, arteriovenous malformation. We report a case of postpartum hemorrhage following cesarean delivery attributed to a pseudoaneurysm of the uterine pedicle and treated with arterial embolization. Angiographic study confirmed the diagnosis and embolization of the false aneurysm was successful in controlling the hemorrhage.

Keyword

Cesarean section; Postpartum hemorrhage; Pseudoanuerysm; Arterial embolization

MeSH Terms

Aneurysm, False*
Arteries
Arteriovenous Malformations
Blood Transfusion
Cesarean Section*
Diagnosis
Diagnosis, Differential
Diethylstilbestrol
Emergencies
Female
Hemorrhage
Humans
Hysterotomy
Parents
Postpartum Hemorrhage*
Postpartum Period*
Pregnancy
Rupture
Trophoblasts
Ultrasonography
United Nations
Diethylstilbestrol