title: Secondary postpartum hemorrhage due to uterine artery pseudoaneurysm rupture in von Willebrand disease.
abstract: We here report a case of a 33-year-old woman who experienced secondary postpartum hemorrhage (PPH) due to uterine artery pseudoaneurysm rupture. She had intrauterine balloon tamponade for unexplained primary PPH after spontaneous vaginal delivery, and subsequent angiography showed no abnormal contrast extravasation. However, profuse vaginal bleeding occurred 22 days postpartum. Color Doppler ultrasonography demonstrated an anechoic mass with turbulent flow in the lower uterine segment, corresponding to uterine artery pseudoaneurysm. She was successfully treated with selective uterine arterial embolization. Decreased levels of von Willebrand factor and factor VIII led to the diagnosis of von Willebrand disease. When it is determined that a patient has unexplained PPH or uterine artery pseudoaneurysm, a high index of suspicion and further investigation for underlying bleeding disorders is warranted.
authors: Department of Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors: Misao
authors: M
authors: Shimizu
authors: Eiji
authors: E
authors: Kondoh
authors: Masashi
authors: M
authors: Ueda
authors: Kazuyo
authors: K
authors: Kakui
authors: Keiji
authors: K
authors: Tatsumi
authors: Ikuo
authors: I
authors: Konishi
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000150:complications* / Q000628:therapy; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000628:therapy; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D055988:Uterine Artery; D055357:Uterine Artery Embolization; D014842:von Willebrand Diseases / Q000150:complications*