Archives of Gynecology and Obstetrics

, Volume 289, Issue 3, pp 469–470 | Cite as

Uterine artery pseudoaneurysm: a master of deception

  • Shigeki MatsubaraEmail author
  • Tomoyuki Kuwata
  • Rie Usui
  • Akihide Ohkuchi
Letter to the Editor

To the Editor,

I read the article, “Delayed postpartum hemorrhage: the implications of making a diagnostic mistake” by Surico et al. [1]. Postpartum hemorrhage (PPH) occurred after cesarean section (CS): a vascular abnormality was initially considered the culprit but uterine scar dehiscence proved to be its true culprit. The context of this article is that (1) PPH sometimes leads to a “diagnostic mistake”, and (2) hysteroscopy should be performed to confirm the diagnosis of PPH. We wish to comment on these two points.

First, we partly agree with Surico et al. first opinion: PPH sometimes leads to a “diagnostic mistake”. However, we would like the readers to recall uterine artery pseudoaneurysm (UAP), which has recently attracted wider attention as a causative disorder of PPH. Yes, PPH sometimes leads to a “diagnostic mistake”; however, not coexistence of, or misunderstanding as, vascular abnormality but UAP (acquired vascular abnormality) itself may lead to a “diagnostic mistake”.

In a...


Cesarean Section Postpartum Hemorrhage Color Doppler Sign Anechoic Area Initial Embolization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

We declare no conflicts of interest.


  1. 1.
    Surico D, Codecà C, Vigone A, Surico N (2013) Delayed postpartum hemorrhage: the implications of making a diagnostic mistake. Arch Gynecol Obstet 287:1053–1054 Google Scholar
  2. 2.
    Matsubara S (2011) Pseudoaneurysm; a chameleon in obstetrical emergency practice. Arch Gynecol Obstet 283:669–670PubMedCrossRefGoogle Scholar
  3. 3.
    Matsubara S, Takahashi Y, Usui R, Nakata M, Kuwata K, Suzuki M (2010) Uterine artery pseudoaneurysm manifesting postpartum hemorrhage after uneventful second-trimester pregnancy termination. J Obstet Gynaecol Res 36:856–860PubMedCrossRefGoogle Scholar
  4. 4.
    Kuwata T, Matsubara S, Kaneko Y, Izumi A, Nakata M, Suzuki M (2010) Asymptomatic uterine artery pseudoaneurysm after cesarean section. J Obstet Gynaecol Res 36:405–410PubMedCrossRefGoogle Scholar
  5. 5.
    Kitahara T, Sato Y, Kakui K, Tatsumi K, Fujiwara H, Konishi I (2011) Management of retained products of conception with marked vascularity. J Obstet Gynaecol Res 37:458–464PubMedCrossRefGoogle Scholar
  6. 6.
    Matsubara S, Kuwata T, Okuno S, Nakata M (2011) Retained products of conception with marked vascularity: pseudoaneurysm hidden behind it. J Obstet Gynaecol Res 37:965PubMedCrossRefGoogle Scholar
  7. 7.
    Matsubara S, Usui R, Sato T, Kuwata T, Ohkuchi A, Nakata M (2013) Adenomyomectomy, curettage, and then uterine artery pseudoaneurysm occupying the entire uterine cavity. J Obstet Gynaecol Res 39:1103–1106Google Scholar
  8. 8.
    Bouchet P, Chabrot P, Fontarensky M, Delabaere A, Bonnin M, Gallot D (2012) Pitfalls for diagnosis of uterine artery pseudoaneurysm after cesarean section. Ultrasound Obstet Gynecol 40:482–483PubMedCrossRefGoogle Scholar
  9. 9.
    Matsubara S, Usui R, Watanabe T, Imayoshi M, Ichida M, Ando Y (2013) Perimortem cesarean section or perimortem cesarean supracervical hysterectomy? Arch Gynecol Obstet 287:389–390Google Scholar
  10. 10.
    Mammen T, Shanthakumari H, Gopi K, Lionel J, Ayyappan AP, Kekre A (2006) Iatrogenic secondary post-partum haemorrhage: apropos of two uncommon cases. Australas Radiol 50:392–394PubMedCrossRefGoogle Scholar
  11. 11.
    Henrich W, Fuchs I, Luttkus A, Hauptmann S, Dudenhausen JW (2002) Pseudoaneurysm of the uterine artery after cesarean delivery: sonographic diagnosis and treatment. J Ultrasound Med 21:1431–1434PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Shigeki Matsubara
    • 1
    Email author
  • Tomoyuki Kuwata
    • 1
  • Rie Usui
    • 1
  • Akihide Ohkuchi
    • 1
  1. 1.Department of Obstetrics and GynecologyJichi Medical UniversityTochigiJapan

Personalised recommendations