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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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How to cite this article
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 - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Shivani Parikh - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Michael Holbert - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter 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.
