Rupture of pseudoaneurysm after vaginal delivery successfully treated by selective arterial embolization.
BACKGROUND
Rupture of a pseudoaneurysm after vaginal delivery is a rare cause of postpartum hemorrhage.


METHODS
A 29-year-old primigravida delivered a healthy boy by vacuum extraction at 38 weeks of gestation. The patient underwent repair of a right mediolateral episiotomy and left vaginal wall laceration. On the third postpartum day she experienced massive vaginal bleeding with vaginal wall laceration, and the vaginal bleeding progressively increased. A selective angiogram of the left internal iliac artery showed a pseudoaneurysm with extravasation originating from the left internal pudendal artery. Complete occlusion of the pseudoaneurysm was achieved by embolization of the left internal pudendal artery. The postprocedural course was uneventful.


CONCLUSIONS
A pseudoaneurysm should be considered in unclear cases of postpartum hemorrhage.
Nagayama
Chiaki
C
Department of Obstetrics and Gynecology, Faculty of Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, Japan.
Gibo
Masaki
M
Nitta
Hayase
H
Uezato
Tadakazu
T
Hirakawa
Makoto
M
Masamoto
Hitoshi
H
Sakumoto
Kaoru
K
Aoki
Yoichi
Y
D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000792:Angiography / Q000379:methods; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D008297:Male; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D011247:Pregnancy; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D055357:Uterine Artery Embolization / Q000379:methods*; D014621:Vagina / Q000098:blood supply / Q000293:injuries