Skip to main content
SpringerLink
Log in

Intractable Postpartum Hemorrhage Resulting from Uterine Artery Pseudoaneurysm: Superselective Arteriographic Embolization via the Collateral Route

  • CASE REPORT
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

We present a patient with intractable postpartum hemorrhage resulting from uterine artery pseudoaneurysm despite bilateral hypogastric artery ligation who was successfully treated by an endovascular approach via the collateral route. Although there is a good argument for postponing surgery until transcatheter embolization has been attempted, this case shows that embolization can still be successful even if the iliac vessels have been ligated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.

Similar content being viewed by others

References

  1. Combs CA, Murphy EL, Laros RK (1991) Factors associated with postpartum haemorrhage with vaginal birth. Obstet Gynecol 77:69–76

    PubMed  CAS  Google Scholar 

  2. Combs CA, Murphy EL, Laros RK (1991) Factors associated with haemorrhage in cesarean deliveries. Obstet Gynecol 77:77–82

    PubMed  CAS  Google Scholar 

  3. Herbert WP, Cefalo RC (1984) Management of post-partum haemorrhage. Clin Obstet Gynecol 27:139–147

    Article  PubMed  CAS  Google Scholar 

  4. Lau WC, Fung HY, Rogers MS (1997) Ten years experience of caesarean and post-partum hysterotomy in a teaching hospital in Hong Kong. Eur J Obstet Gynecol Reprod Biol 73:133–137

    Article  Google Scholar 

  5. Greenwood LH, Glickman MG, Schwartz PE, Morse SS, Denny DF (1987) Obstetric and nonmalignant gynecologic bleeding: Treatment with angiographic embolization. Radiology 164:155–159

    PubMed  CAS  Google Scholar 

  6. Brown BJ, Heaston DK, Poulson AM, Gabert HA, Mineau DE, Miller FJ Jr (1979) Uncontrollable postpartum bleeding: A new approach to hemostasis through angiographic arterial embolization. Obstet Gynecol 54:361–365

    PubMed  CAS  Google Scholar 

  7. Collins CD, Jackson JE (1995) Pelvic arterial embolization following hysterectomy and bilateral internal iliac artery ligation for intractable primary post partum haemorrhage. Clin Radiol 50:710–714

    Article  PubMed  CAS  Google Scholar 

  8. Sproule MW, Bendomir AM, Grant KA, Reid AW (1994) Embolisation of massive bleeding following hysterectomy, despite internal iliac artery ligation. Br J Obstet Gynaecol 101:908–909

    PubMed  CAS  Google Scholar 

  9. Krantikumar RR, Hemant LD, Ashwin A, Vinita SS, Santoshi P (2005) Successful embolization of ovarian artery pseudoaneurysm complicating obstetric hysterectomy. Cardiovasc Intervent Radiol 28:113–116

    Article  Google Scholar 

  10. Gilbert L, Porter W, Brown VA (1987) Post-partum haemorrhage: A continuing problem. Br J Obstet Gynecol 94:67–71

    CAS  Google Scholar 

  11. King PA, Duthie SJ, Dong ZG, Ma HK (1989) Secondary postpartum haemorrhage. Aust N Z J Obstet Gynecol 29:394–398

    CAS  Google Scholar 

  12. Brunschwig A, Brockunier A (1960) Postoperative rupture of major vessels after radical pelvic operation. Am J Obstet Gynecol 80:485–489

    PubMed  CAS  Google Scholar 

  13. Cooper JM, Hester LL (1975) Iliac artery aneurysm presenting as a complication of hysterectomy. Obstet Gynecol 45:689–690

    Article  PubMed  CAS  Google Scholar 

  14. Burchell RC (1968) Physiology of internal iliac artery ligation. J Obstet Gynaecol Br Commonw 75:642–651

    PubMed  CAS  Google Scholar 

  15. Vedantham S, Goodwin SC, McLucas B, Mohr G (1997) Uterine artery embolization: An under used method of controlling pelvic hemorrhage. Am J Obstet Gynecol 176:938–948

    Article  PubMed  CAS  Google Scholar 

  16. Boulleret C, Chahid T, et al. (2004) Hypogastric arterial selective and superselective embolization for severe postpartum hemorrhage: A retrospective review of 36 cases. Cardiovasc Intervent Radiol 27:344–34

    Article  Google Scholar 

  17. Markoff G, Quagliarello J, Rosen RJ, Beckman EM (1986) Uterine arteriovenous malformation successfully embolized with a liquid polymer, isobutyl 2-cyanoacrylate. Am J Obstet Gynecol 155:659–660

    PubMed  CAS  Google Scholar 

  18. Rosenthal DM, Colapinto R (1985) Angiographic arterial embolisation in the management of postoperative vaginal hemorrhage. Am J Obstet Gynecol 151:227–231

    PubMed  CAS  Google Scholar 

  19. Hare WSC, Holland CJ (1983) Paresis following internal iliac artery embolization. Radiology 146:47–51

    PubMed  CAS  Google Scholar 

  20. Behnam K, Jarmolowski CR (1982) Vesicovaginal fistula following hypogastric embolization for control of intractable pelvic hemorrhage. J Reprod Med 27:304–306

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, S.B. Diskapi Yildirim Beyazit Egitim ve Arastirma Hastanesi, TR-06110, Diskapi, Ankara, Turkey

    Halil Dönmez, M. Halil Öztürk, Fatma Gürgen, Serra Ö. Soylu & Baki Hekimoglu

  2. Harbiye Mah. Nisan sok. 32/22, TR- 06640, Dikmen, Ankara, Turkey

    Halil Dönmez

Authors
  1. Halil Dönmez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Halil Öztürk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fatma Gürgen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Serra Ö. Soylu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Baki Hekimoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Halil Dönmez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dönmez, H., Öztürk, M.H., Gürgen, F. et al. Intractable Postpartum Hemorrhage Resulting from Uterine Artery Pseudoaneurysm: Superselective Arteriographic Embolization via the Collateral Route. Cardiovasc Intervent Radiol 30, 310–312 (2007). https://doi.org/10.1007/s00270-006-0043-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-006-0043-6

Keywords

Search

Navigation