Key result
Interventional embolization manages ~83% of uterine artery pseudoaneurysms in pregnancy, emerging as the preferred treatment.
Why the study?
Management strategies for uterine artery (pseudo)aneurysm during pregnancy, including treatment options and delivery timing, are not well established.
Embolization appears to be the method of choice for managing uterine artery (pseudo)aneurysms during pregnancy, though optimal delivery mode and timing require further investigation.
Embolization may be favored for uterine artery pseudoaneurysms in pregnancy; leaves optimal delivery mode and timing unresolved.
PURPOSE: To describe the management of uterine artery (pseudo)aneurysm, ruptured or unruptured, during pregnancy. METHODS: After reporting a case about this rare pathology, a review of the literature was performed. The search was applied to PubMed databases. RESULTS: A total of eighteen articles met the inclusion criteria. Eighteen patients were reported. Eight (44.4 %) patients didn't have prior medical or surgical history. Fifteen (83.3 %) beneficed interventional radiology method during pregnancy including two cases (13.3 %) with repeated embolization because of recanalization of the (pseudo)aneurysm. Nine patients (50 %) beneficed a planned cesarean between 34 and 39 weeks of gestation. One (15.8 %) patient was diagnosed with fetal death before treatment of the uterine artery (pseudo)aneurysm. CONCLUSION: The decision to proceed to the treatment of the (pseudo)aneurysm must consider several factors, associated or not with a good fetal vitality and a hemodynamically stable patient. Embolization appears to be the method of choice. Mode of delivery and term remain not clear and contraindication of expulsive efforts in case of a uterine artery (pseudo)aneurysm merit further investigations.
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Crouzat et al. (2024) conducted a review in Uterine artery (pseudo)aneurysm during pregnancy (n=18). Interventional radiology (embolization) was evaluated on Use of interventional radiology method during pregnancy. In a review of 18 pregnant patients with uterine artery (pseudo)aneurysm, 83.3% were managed with interventional radiology, indicating embolization as the preferred treatment method.
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