Key result
Three-dimensional computed tomography angiography effectively diagnosed a uterine artery pseudoaneurysm causing secondary postpartum hemorrhage, enabling successful transarterial embolization.
Why the study?
Uterine artery pseudoaneurysm is a rare cause of secondary postpartum hemorrhage.
Case Report (n=1)
No
Three-dimensional computed tomography angiography is an effective diagnostic tool for uterine artery pseudoaneurysm when ultrasound is inconclusive.
Answers are grounded in this paper and cite their sources.
Supports consideration of 3D CT angiography after inconclusive ultrasound in secondary postpartum hemorrhage; leaves open need for prospective validation.
Uterine artery pseudoaneurysm is a rare cause of secondary postpartum hemorrhage. Herein, we report a case of uterine artery pseudoaneurysm, with postpartum hemorrhage commencing 22 days after uncomplicated vaginal delivery. Intermittent bleeding occurred during conservative observation. Transvaginal ultrasound color Doppler imaging revealed swollen vascular structures that suggested arteriovenous malformations, and a saccular dilatation of blood vessels. However, it was insufficient to definitively diagnose the condition as pseudoaneurysm. Meanwhile, the three-dimensional computed tomography angiogram was effective in demonstrating a pseudoaneurysm in the uterus, and an absent early venous return sign, leading to the final diagnosis of a pseudoaneurysm. The patient was successfully treated with transarterial embolization using gelatin sponge pledgets. No bleeding or recurrence of the pseudoaneurysm was observed 2 months after embolization.
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Iwahata et al. (2021) conducted a case report in Uterine arterial pseudoaneurysm causing secondary postpartum hemorrhage (n=1). Three-dimensional computed tomography angiography (3D-CTA) was evaluated on Accurate diagnosis and successful hemostasis. Three-dimensional computed tomography angiography effectively diagnosed a uterine artery pseudoaneurysm causing secondary postpartum hemorrhage, enabling successful transarterial embolization.
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