In four cases of uterine artery pseudoaneurysm, lesions consistently emerged at the placental attachment site, suggesting placental attachment and detachment processes may drive UAP development.
Case Report (n=4)
Placental attachment and detachment processes, combined with predisposing traumatic factors, may be associated with the development of uterine artery pseudoaneurysms.
We present four distinct cases of uterine artery pseudoaneurysm (UAP) with secondary postpartum hemorrhage, in which their unique characteristics including the implicated arteries and their localization were delineated using contrast-enhanced computed tomography and uterine artery angiography. Three cases had a history of intrauterine manipulation procedures, which included in vitro fertilization/embryo transfer and surgical abortion. The UAPs emerged consistently at the placental attachment site. Notably, for the two cases with cesarean sections, the UAPs were formed in locations unrelated to myometrial incisions. These pseudoaneurysms manifested with radial or arcuate arteries. Three cases with extravasation exhibited hypofibrinogenemia and elevated D-dimer. These findings suggest that the intricate processes of placental attachment and detachment during pregnancy and delivery, possibly when combined with recognized predisposing factors including traumatic incidents prior to and/or during gestation and/or after parturition, may be associated with development of UAP. Consumptive coagulopathy may be a contributing factor for UAP extravasation.
Ikeda et al. (Mon,) conducted a case report in Uterine artery pseudoaneurysm with secondary postpartum hemorrhage (n=4). Placental attachment and detachment processes and traumatic incidents was evaluated on Development of uterine artery pseudoaneurysm. In four cases of uterine artery pseudoaneurysm, lesions consistently emerged at the placental attachment site, suggesting placental attachment and detachment processes may drive UAP development.