Perinatology.  2023 Mar;34(1):23-27. 10.14734/PN.2023.34.1.23.

Intraoperative Computed Tomography for Identifying Bleeding Focus in Spontaneous Rupture of Uterine Artery during Pregnancy: A Case Report

• Kim S
• Kim Y
• Kyeong KS
• Kim SH
• Lee MH
• Cho HY
• Kyung MS
• Kang JB

• KMID: 2544106
• DOI: http://doi.org/10.14734/PN.2023.34.1.23

Abstract

A 35-year-old pregnant woman, para 0, who had previous medical history of lymphoma, visited to our hospital at 18 weeks and 2 days of gestation with chief complaint of suprapubic pain. Small amount of abdominal fluid collection was seen on initial ultrasonography and normal appendix on magnetic resonance imaging. However, after 6 hours later, she underwent emergency diagnostic exploratory laparoscopy due to aggravating abdominal pain and hypotension. Bleeding focus was hardly found due to its location and enlarged uterus, intraoperative enhanced computed tomography (CT) scan was done and left uterine artery was identified as the site of bleeding. Spontaneous rupture of a uterine artery in pregnancy is rare and can cause fatal consequence but clinical signs and symptoms were not specific. Some bleeding sites would be difficult to find in diagnostic exploration and may cause more blood loss and worse obstetric complications. Contrast-enhanced CT can clearly confirm bleeding site comparing with other modality. Therefore, preoperative contrast CT scan can be performed to obtain better outcome.

Keyword

Hemoperitoneum; Pregnancy; Uterine artery