Embolization of a postcesarean pseudo-aneurysm of a uterine artery: A case report

Abstract

Postpartum hemorrhage caused by a pseudoaneurysm of the uterine artery is suspected clinically in the case of abundant metrorrhagia. An ultrasound is performed, followed by further imaging modalities to confirm the diagnosis: CT scan, MRI, and angiography, the latter would also allow embolization. This is admittedly rare, however, since the pseudo aneurysm of the uterine artery is potentially fatal, it must be taken into account in the differential diagnosis of secondary postpartum hemorrhage, allowing adequate and rapid management. We report a case of pseudo aneurysm of the uterine artery, suspected clinically and confirmed by a CT scan, presenting as a secondary postpartum hemorrhage a few hours after delivery by cesarean section. It was eventually managed by embolization with excellent results several days after its onset when the cause was revealed. Angiographic embolization is an effective treatment for postpartum hemorrhage caused by pseudoaneurysm in stable patients. It should be considered before surgery in suitable cases.

Keywords

• Pseudoaneurysm of uterine artery
• Postpartum hemorrhage
• Morbidity
• Doppler
• Angiography
• Embolization