Archives of Gynecology and Obstetrics

, Volume 290, Issue 3, pp 435–440 | Cite as

Uterine artery pseudoaneurysm: not a rare condition occurring after non-traumatic delivery or non-traumatic abortion

  • Yosuke Baba
  • Shigeki MatsubaraEmail author
  • Tomoyuki Kuwata
  • Akihide Ohkuchi
  • Rie Usui
  • Miyuki Saruyama
  • Manabu Nakata
  • Mitsuaki Suzuki
Maternal-Fetal Medicine



Uterine artery pseudoaneurysm (UAP) is considered a rare disorder after traumatic delivery or traumatic pregnancy termination such as cesarean section or dilatation and curettage, initially manifesting as genital hemorrhage. Our clinical impression contradicts these three assumptions; after traumatic delivery/termination, hemorrhage, and its rarity. Thus, we attempted to clarify these three issues.


We retrospectively analyzed 22 UAP cases treated at our institute over a 6-year period.


Uterine artery pseudoaneurysm occurred in 2–3/1,000 deliveries. Of 22 cases, half occurred after non-traumatic deliveries or non-traumatic pregnancy termination. Fifty-five percent (12/22) showed no hemorrhage; ultrasound or color Doppler revealed UAP. Thus, half of UAP occurred after non-traumatic deliveries or non-traumatic pregnancy termination and showed no hemorrhage at the time of their diagnoses. All patients received transarterial embolization, which stopped blood flow into UAP or achieved hemostasis.


We must be aware that UAP may not be so rare and it may be present in patients after non-traumatic deliveries/pregnancy termination and without postpartum or postabortal hemorrhage.


Cesarean section Postabortal hemorrhage Postpartum hemorrhage Pseudoaneurysm Uterine artery pseudoaneurysm 



Cesarean section


Dilatation and curettage


Postpartum hemorrhage


Uterine artery pseudoaneurysm


Conflict of interest

The authors declare that they have no conflict of interest regarding this article.


  1. 1.
    Soyer P, Fargeaudou Y, Morel O, Boudiaf M, Le Dref O, Rymer R (2008) Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization. Eur Radiol 18(6):1181–1187PubMedCrossRefGoogle Scholar
  2. 2.
    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(2):405–410PubMedCrossRefGoogle Scholar
  3. 3.
    Eriksson LG, Mulic-Lutvica A, Jangland L, Nyman R (2007) Massive postpartum hemorrhage treated with transcatheter arterial embolization: technical aspects and long-term effects on fertility and menstrual cycle. Acta Radiol 48(6):635–642PubMedCrossRefGoogle Scholar
  4. 4.
    Wald DA (2003) Postpartum hemorrhage resulting from uterine artery pseudoaneurysm. J Emerg Med 25(1):57–60PubMedCrossRefGoogle Scholar
  5. 5.
    Nagayama C, Gibo M, Nitta H, Uezato T, Hirakawa M, Masamoto H, Sakumoto K, Aoki Y (2011) Rupture of pseudoaneurysm after vaginal delivery successfully treated by selective arterial embolization. Arch Gynecol Obstet 283(1):37–40PubMedCrossRefGoogle Scholar
  6. 6.
    Kim YA, Han YH, Jun KC, Jeon MK, Lee ES (2008) Uterine artery pseudoaneurysm manifesting delayed postabortal bleeding. Fertil Steril 90(3):849 e11–849 e14CrossRefGoogle Scholar
  7. 7.
    Webber GW, Jang J, Gustavson S, Olin JW (2007) Contemporary management of postcatheterization pseudoaneurysms. Circulation 115(20):2666–2674PubMedCrossRefGoogle Scholar
  8. 8.
    Matsubara S, Takahashi Y, Usui R, Nakata M, Kuwata T, Suzuki M (2010) Uterine artery pseudoaneurysm manifesting as postpartum hemorrhage after uneventful second-trimester pregnancy termination. J Obstet Gynaecol Res 36(4):856–860PubMedCrossRefGoogle Scholar
  9. 9.
    Matsubara S (2011) Pseudoaneurysm: a chameleon in obstetrical emergency practice. Arch Gynecol Obstet 283(3):669–670PubMedCrossRefGoogle Scholar
  10. 10.
    Matsubara S, Kuwata T, Usui R, Ohkuchi A (2014) Uterine artery pseudoaneurysm: a master of deception. Arch Gynecol Obstet 289(3):469–470PubMedCrossRefGoogle Scholar
  11. 11.
    Matsubara S, Kobayashi M, Baba Y, Usui R (2014) Uterine artery pseudoaneurysm rupture as a culprit of postpartum hemorrhage: not always after cesarean section. J Emerg Med 46(3):e97–e98PubMedCrossRefGoogle Scholar
  12. 12.
    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(5):1103–1106PubMedCrossRefGoogle Scholar
  13. 13.
    Matsubara S, Nakata M, Baba Y, Suzuki H, Nakamura H, Suzuki M (2014) Uterine artery pseudoaneurysm hidden behind septic abortion: pseudoaneurysm without preceding procedure. J Obstet Gynaecol Res 40(2):586–589PubMedCrossRefGoogle Scholar
  14. 14.
    McGonegle SJ, Dziedzic TS, Thomas J, Hertzberg BS (2006) Pseudoaneurysm of the uterine artery after an uncomplicated spontaneous vaginal delivery. J Ultrasound Med 25(12):1593–1597PubMedGoogle Scholar
  15. 15.
    Dohan A, Soyer P, Subhani A, Hequet D, Fargeaudou Y, Morel O, Boudiaf M, Gayat E, Barranger E, Le Dref O, Sirol M (2013) Postpartum hemorrhage resulting from pelvic pseudoaneurysm: a retrospective analysis of 588 consecutive cases treated by arterial embolization. Cardiovasc Intervent Radiol 36(5):1247–1255PubMedCrossRefGoogle Scholar
  16. 16.
    Isono W, Tsutsumi R, Wada-Hiraike O, Fujimoto A, Osuga Y, Yano T, Taketani Y (2010) Uterine artery pseudoaneurysm after cesarean section: case report and literature review. J Minim Invasive Gynecol 17(6):687–691PubMedCrossRefGoogle Scholar
  17. 17.
    Kim GM, Yoon CJ, Seong NJ, Kang SG, Kim YJ (2013) Postpartum haemorrhage from ruptured pseudoaneurysm: efficacy of transcatheter arterial embolisation using N-butyl-2-cyanoacrylate. Eur Radiol 23(8):2344–2349PubMedCrossRefGoogle Scholar
  18. 18.
    Yahyayev A, Guven K, Bulakci M, Ucar A, Aghayev A, Yekeler E (2011) Spontaneous thrombosis of uterine artery pseudoaneurysm: follow-up with doppler ultrasonography and interventional management. J Clin Ultrasound 39(7):408–409PubMedCrossRefGoogle Scholar
  19. 19.
    Maassen MS, Lambers MD, Tutein Nolthenius RP, van der Valk PH, Elgersma OE (2009) Complications and failure of uterine artery embolisation for intractable postpartum haemorrhage. BJOG 116(1):55–61PubMedCrossRefGoogle Scholar
  20. 20.
    Toor SS, Jaberi A, Macdonald DB, McInnes MD, Schweitzer ME, Rasuli P (2012) Complication rates and effectiveness of uterine artery embolization in the treatment of symptomatic leiomyomas: a systematic review and meta-analysis. AJR 199(5):1153–1163PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Yosuke Baba
    • 1
  • Shigeki Matsubara
    • 1
    Email author
  • Tomoyuki Kuwata
    • 1
  • Akihide Ohkuchi
    • 1
  • Rie Usui
    • 1
  • Miyuki Saruyama
    • 1
  • Manabu Nakata
    • 2
  • Mitsuaki Suzuki
    • 1
  1. 1.Department of Obstetrics and GynecologyJichi Medical UniversityShimotsukeJapan
  2. 2.Department of RadiologyJichi Medical UniversityShimotsukeJapan

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