Pelvic arterial pseudoaneurysm-a rare complication of Cesarean section: diagnosis and novel treatment.
An uncommon cause of delayed postpartum hemorrhage is a pseudoaneurysm of the uterine artery. Pelvic arterial pseudoaneurysm is generally treated by laparotomy and hemostatic sutures or by uterine artery embolization. We describe two cases of late postpartum hemorrhage following Cesarean section, attributed to pelvic arterial pseudoaneurysm, that were successfully treated by direct thrombin injection under ultrasound guidance. Percutaneous or transvaginal ultrasound-guided direct thrombin injection is a simple procedure that does not require any sophisticated surgical or radiological equipment.
Kovo
M
M
Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. michalkovo@gmail.com
Behar
D J
DJ
Friedman
V
V
Malinger
G
G
D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007269:Injections, Intra-Arterial; D006473:Postpartum Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D013917:Thrombin / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*
D006490:Hemostatics; D013917:Thrombin