False aneurysm of the uterine pedicle: an uncommon cause of post-partum haemorrhage after caesarean section treated with selective arterial embolization.
ABSTRACT We report three cases of post-partum haemorrhage following caesarean delivery attributed to a false aneurysm of the uterine pedicle and treated with artery embolization. These lesion were probably post-traumatic in origin related to hysterotomy. Angiographic study of the anterior division of hypogastric arteries confirmed the diagnosis and embolization of the false aneurysm was successful in controlling the haemorrhage.
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ABSTRACT: Transcatheter arterial embolization has recently emerged as a highly effective percutaneous technique for controlling acute and chronic genital bleeding in a wide variety of obstetric and gynecologic disorders. Benefits for the patient and health care system have included low complication rates, avoidance of surgical risks, fertility preservation, and shorter hospitalizations. In this article the current indications for pelvic embolotherapy, types of embolotherapy, technical considerations, immediate success rates, causes of failure, complications, and outcome expectations are discussed. Our comprehensive literature review and clinical experience suggest that embolization should be used before surgical treatment of nonmalignant pelvic bleeding in many clinical settings, including postpartum, postcesarean, and postoperative bleeding. It is our strong belief that this form of therapy is underused, and the primary purpose of this article is to emphasize its developing role as a highly effective, relatively noninvasive method of treating genital bleeding.American Journal of Obstetrics and Gynecology 05/1997; 176(4):938-48. · 3.88 Impact Factor
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ABSTRACT: Preexisting aneurysms in several arterial locations have been associated with an increased risk of rupture in pregnancy. We report a rare case of uterine artery pseudoaneurysm that presented during the puerperium. A 31-year-old woman had moderate suprapubic pain on postpartum day 8. The diagnosis of uterine artery aneurysm was made by duplex Doppler sonography and confirmed by arteriography. It was successfully treated by embolization of the left uterine artery. In a rare case of pseudoaneurysm of the uterine artery, the complications of pregnancy-related aneurysmal rupture were prevented by prompt sonographic diagnosis and embolization therapy.Obstetrics and Gynecology 12/1999; 94(5 Pt 2):827-30. · 4.80 Impact Factor
Article: Secondary postpartum haemorrhage.[show abstract] [hide abstract]
ABSTRACT: Eighty-three cases of secondary postpartum haemorrhage managed in this teaching unit over a 3-year period are described. Bleeding occurred most frequently between the 8th and 14th day of the puerperium; 73% of the patients had already been discharged from hospital and required readmission. Suction evacuation was performed in 72 patients and was successful in arresting haemorrhage whether retained placental tissue could be demonstrated on histology or not. There was histological confirmation of retained gestational products in only 30 (42%) of the patients treated surgically. No predictive factors for secondary postpartum haemorrhage could be identified in the obstetric profiles or antenatal course of most of these patients. Patients with retained gestational products could not be distinguished from those without on the basis of history or examination alone apart from 4 patients noted to have incomplete membranes at delivery.Australian and New Zealand Journal of Obstetrics and Gynaecology 12/1989; 29(4):394-8. · 1.30 Impact Factor