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Pseudoaneurysm of uterine artery complicating caesarean section: a rare cause of intractable secondary postpartum haemorrhage managed with uterine artery embolisation
  1. Aishvarya Gupta1,2,
  2. Haritha Sagili2,
  3. Nagarajan Krishnan3 and
  4. Papa Dasari2
  1. 1Obstetrics and Gynecology, Indraprastha Apollo Hospital, New Delhi, India
  2. 2Obstetrics and Gynaecology, JIPMER, Puducherry, Pondicherry, India
  3. 3Department of Radiodiagnosis, JIPMER, Puducherry, Pondicherry, India
  1. Correspondence to Dr Aishvarya Gupta; aishvaryagupta88{at}gmail.com

Abstract

A 27-year-old woman presented 6 weeks after an uncomplicated lower segment caesarean section with excessive bleeding per vagina. On examination, she had mild pallor with a pulse rate of 86 beats per minute and blood pressure of 116/80 mm Hg, uterus well involuted with closed cervical os and bleeding demonstrated through the cervix. A transvaginal ultrasonography with colour Doppler revealed a normal size uterus with an empty cavity and a hypoechoic area with blood flow within it in the left side of the uterus with a prominent arterial feeder vessel. A CT angiogram confirmed the diagnosis of a 1.3×0.7 cm pseudoaneurysm of the uterine artery near the left cornua of the uterus. After failed attempts to control the bleeding with antifibrinolytics, bilateral uterine arteries were embolised using gel foam. Post procedure, bleeding resolved immediately. A follow-up transvaginal ultrasound after a year revealed no evidence of the pseudoaneurysm and her fertility was preserved.

  • pregnancy
  • interventional radiology

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Footnotes

  • Contributors AG, HS, NK and PD contributed to the conception or design of the work, and the acquisition, analysis and interpretation of data. AG and HS contributed to drafting the work and revising it critically for important intellectual content. Final approval of the version of the manuscript was given by all authors. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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