scholarly journals Uterine artery pseudoaneurysm after treatment of cesarean scar pregnancy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiao Wang ◽  
Qing Yang ◽  
Ningning Zhang ◽  
Dandan Wang
Keyword(s):  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Rare Complication ◽  
Transvaginal Ultrasound ◽  
Massive Hemorrhage ◽  
Cesarean Scar Pregnancy ◽  
Artery Pseudoaneurysm ◽  
Cesarean Scar ◽  
Effective Diagnosis ◽  
Uterine Artery Pseudoaneurysm

Abstract Background Pseudoaneurysms are formed when a local arterial wall ruptures, leading to hemorrhage and hematoma adjacent to the artery. Continuous perfusion of the injured artery increases the pressure in the lumen of the pseudoaneurysm. It may rupture and lead to massive hemorrhage that could be life-threatening. Cesarean scar pregnancy (CSP) is an ectopic pregnancy where the gestational sac is implanted in the cesarean scar. Uterine artery pseudoaneurysm (UAP) after CSP treatment is rare. Case presentation We report the case of a 36-year-old Chinese woman who presented with acute massive vaginal bleeding 53 days after transabdominal scar pregnancy excision. Doppler ultrasound confirmed UAP. Selective uterine artery embolization (UAE) failed because of the thin and curved blood vessels. The lesion decreased in size after transvaginal ultrasound-guided direct thrombin injection (UGTI); however, massive vaginal bleeding recurred and endangered the patient’s life. The uterus was removed thereafter. Conclusions UAP is a rare complication after CSP treatment that can lead to fatal massive hemorrhage. Ultrasound should be reexamined regularly after treatment of CSP. In case of unexplained vaginal bleeding, we should be alert to the existence of UAP and the possibility of rupture and take effective diagnosis and treatment measures promptly.

scholarly journals Pseudoaneurysm of the uterine artery post loop electrosurgical excision procedure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Judith Ong ◽  
Kelvin Lee ◽  
Soe-Na Choo ◽  
Stanley Loh ◽  
Li Min Lim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Management Options ◽  
Artery Pseudoaneurysm ◽  
Image Guided ◽  
Computed Tomography Angiogram ◽  
Uterine Artery Pseudoaneurysm ◽  
Loop Electrosurgical Excision ◽  
Loop Electrosurgical Excision Procedure

Abstract Background The formation of a uterine artery pseudoaneurysm is rare and isolated cases have been reported in the existing literature following caesarean sections, curettages and cone biopsies. There has been no report of pseudoaneurysm formation following a loop electrosurgical excision procedure. Vaginal bleeding could potentially be life threatening if this diagnosis is not considered following cervical instrumentation or surgery. Management options range from haemostatic sutures, image-guided embolisation to surgical repair. We report the diagnosis and management of a case of uterine artery pseudoaneurysm after a loop electrosurgical excision procedure. Case presentation A 37-year-old woman was diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3) and underwent a therapeutic loop electrosurgical excision procedure. One month after the procedure, the patient presented to the emergency department with repeated episodes of sudden-onset heavy vaginal bleeding associated with hypotension and syncope. A computed tomography angiogram was performed, which demonstrated a pseudoaneurysm of the right uterine artery. Following the diagnosis, image-guided embolisation was performed successfully. Post-embolisation angiograms showed successful embolisation of the pseudoaneurysm and the patient had no further episodes of bleeding. Conclusions Loop electrosurgical excision procedures are generally safe but rarely, can be complicated by the formation of uterine artery pseudoaneurysms. The depth of the loop electrosurgical excision procedure and vascular anatomy should be considered to prevent such complications. A computed tomography angiogram appears to be ideal for diagnosis. Image-guided embolisation is safe and effective as a therapeutic measure, with minimal morbidity.

scholarly journals Contrast-enhanced ultrasound in uterine artery embolization treatment of cesarean scar pregnancy

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052098021
Author(s):  
Dongmei Liu ◽  
Xiaoning Gu ◽  
Fang Liu ◽  
Fuwen Shi ◽  
Min Yang
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Transvaginal Ultrasound ◽  
Contrast Enhanced Ultrasound ◽  
Artery Embolization ◽  
Time Intensity Curve ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Contrast Enhanced ◽  
Myometrial Thickness

Objective The current study aimed to investigate the application of contrast-enhanced ultrasound (CEUS) in diagnosis and treatment of cesarean scar pregnancy (CSP). Methods A retrospective study was performed in 35 patients with clinically suspected CSP who requested termination of pregnancy and underwent contrast-enhanced ultrasound (CEUS). The patients were classified into two groups on the basis of whether they received uterine artery embolization (UAE). The CEUS characteristics of the two groups were reviewed. Results CEUS features of CSP were early enhancement of the cesarean scar and continuous infusion of contrast agent between the gestational sac and cesarean scar. Myometrial thickness in the cesarean scar was thinner in the UAE group than in the non-UAE group by CEUS and transvaginal ultrasound. Myometrial thickness measured by CEUS was thinner than that measured by transvaginal ultrasound in both groups. The parameters of the time-intensity curve in the UAE group were characterized by a faster arrival time, shorter time to peak, higher peak intensity, and greater enhancement rate compared with the non-UAE group. Conclusions CEUS may be a novel supplementary method to diagnose and assess CSP, and to help evaluate whether UAE is required.

scholarly journals VP06.06: Uterine artery pseudoaneurysm: rare complication of Caesarean section

2021 ◽  
Vol 58 (S1) ◽  
pp. 121-121
Author(s):  
F. Affes ◽  
H. Frikha ◽  
M. Fezzani ◽  
A. Kammoun ◽  
A. Karoui ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Uterine Artery ◽  
Rare Complication ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Pseudoaneurysm

Uterine Artery Pseudoaneurysm: A Case Report

2020 ◽  
Vol 36 (3) ◽  
pp. 273-276
Author(s):  
Mahmoud S. Babiker
Keyword(s):  
Uterine Artery Embolization ◽  
Vaginal Bleeding ◽  
Rare Case ◽  
Uterine Artery ◽  
Arterial Wall ◽  
Caesarian Section ◽  
Artery Embolization ◽  
Artery Pseudoaneurysm ◽  
Arterial Blood ◽  
Uterine Artery Pseudoaneurysm

Pseudoaneurysm is an extraluminal collection of blood with a turbulent flow that communicates with flowing arterial blood through a defect in the arterial wall. Uterine artery pseudoaneurysm (UAP) is considered a rare case that occurs in 2–3/1,000 deliveries. A 33-year-old pregnant woman was admitted for a planned caesarian section. After a successful delivery, the patient experienced a postpartum vaginal bleeding 3 days later. Sonography revealed a suspected right UAP, and the diagnosis was confirmed by angiography. The defect was treated by uterine artery embolization.

scholarly journals Arteriovenous Malformation Complicating Cesarean Scar Pregnancy: A Rare case of Vaginal Bleeding Managed Successfully by Uterine Artery Embolization

2021 ◽  
Author(s):  
Sangam Jha ◽  
Akanksha Singh
Keyword(s):  
Arteriovenous Malformation ◽  
Uterine Artery Embolization ◽  
Vaginal Bleeding ◽  
Uterine Artery ◽  
Color Doppler ◽  
Artery Embolization ◽  
Diagnostic Dilemma ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Future Fertility

Objective: Arteriovenous malformation (AVM) can occur in cesarean scar ectopic pregnancy. The presence of retained product of conception can pose a diagnostic dilemma and clinical presentation could be similar. Case report: A 27 year old female presented with continuous vaginal bleeding for two and half months following dilatation and evacuation (D&E) done for cesarean scar pregnancy (CSP) of 10 weeks 4days period of gestation. Sonography with color Doppler revealed dilated tortuous vessels around the mass in lower uterine segment suggesting CSP with AVM. Digital subtraction angiography confirmed the diagnosis. Bilateral uterine artery embolization achieved complete devascularisation as confirmed on post intervention angiogram. Patient became symptom free since then. Conclusion: Uterine artery embolization is an effective mode of treatment of AVM complicating CSP if future fertility is desired.

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