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CLC number: R737.33

On-line Access: 2017-05-04

Received: 2016-11-24

Revision Accepted: 2017-01-29

Crosschecked: 2017-04-10

Cited: 2

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Citations:  Bibtex RefMan EndNote GB/T7714

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Journal of Zhejiang University SCIENCE B 2017 Vol.18 No.5 P.441-444


Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm

Author(s):  Ning Zhang, Wei-hua Lou, Xue-bin Zhang, Jian-hua Lin, Wen Di

Affiliation(s):  Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200126, China; more

Corresponding email(s):   diwen163@163.com

Key Words:  Postpartum hemorrhage, Antepartum hemorrhage, Uterine artery pseudoaneurysm

Ning Zhang, Wei-hua Lou, Xue-bin Zhang, Jian-hua Lin, Wen Di. Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm[J]. Journal of Zhejiang University Science B, 2017, 18(5): 441-444.

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author="Ning Zhang, Wei-hua Lou, Xue-bin Zhang, Jian-hua Lin, Wen Di",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm
%A Ning Zhang
%A Wei-hua Lou
%A Xue-bin Zhang
%A Jian-hua Lin
%A Wen Di
%J Journal of Zhejiang University SCIENCE B
%V 18
%N 5
%P 441-444
%@ 1673-1581
%D 2017
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1600528

T1 - Antepartum hemorrhage from previous-cesarean-sectioned uterus as a potential sign of uterine artery pseudoaneurysm
A1 - Ning Zhang
A1 - Wei-hua Lou
A1 - Xue-bin Zhang
A1 - Jian-hua Lin
A1 - Wen Di
J0 - Journal of Zhejiang University Science B
VL - 18
IS - 5
SP - 441
EP - 444
%@ 1673-1581
Y1 - 2017
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1600528

postpartum hemorrhage (PPH), a leading cause of maternal mortality, can occur within 24 h of delivery (primary PPH), or during the period from 24 h after delivery to Week 6 of puerperium (secondary PPH). It requires health professionals to be alert to the symptoms to ensure prompt diagnosis and treatment, especially in the case of rupture of a uterine artery pseudoaneurysm (UAP) due to its life-threatening consequence (Baba et al., 2014). Most of the published case reports or case serials describe UAP as a possible cause of delayed PPH after traumatic procedures during delivery or pregnancy termination, including cesarean section (CS), manual removal of the placenta, or dilation and curettage (D&C) (Wald, 2003). Herein, we report a case of prior CS-related UAP manifesting as primary PPH after an uncomplicated vaginal delivery. This case required emergency embolization and is notable for several reasons. antepartum hemorrhage of the previously scarred uterus was a potential sign of the ruptured UAP, and color Doppler sonography sometimes deceived the physician as the characteristic features of UAP did not appear to be present.


方法:病例报道和文献汇纳分析。患者女,37岁,疤痕子宫,临产入院,产前出血,经阴顺产后12 h,突发阴道大量出血,常规对症处理(按摩子宫、阴道填塞、缩宫素静滴和欣母佩宫颈注射等)未能有效缓解,40 min内出血达1800 ml。床边B超未提示动脉瘤特征,数字减影血管造影(DSA)显示左侧子宫动脉瘤,即刻予动脉栓塞成功止血。患者产后4 d无并发症出院,随访无后遗症。


Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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[5]Gondo, S., Urushiyama, D., Yoshizato, T., et al., 2014. The successful detection of postpartum unruptured vaginal pseudoaneurysm using ultrasonography: a case report. SpringerPlus, 3(1):482.

[6]Matsubara, S., Nakata, M., Baba, Y., et al., 2014a. Uterine artery pseudoaneurysm hidden behind septic abortion: pseudoaneurysm without preceding procedure. J. Obstet. Gynaecol. Res., 40(2):586-589.

[7]Matsubara, S., Kuwata, T., Usui, R., et al., 2014b. Uterine artery pseudoaneurysm: a master of deception. Arch. Gynecol. Obstet., 289(3):469-470.

[8]Matsubara, S., Takahashi, H., Ogoyama, M., et al., 2016. Postpartum hemorrhage: is angiographically detectable “sac” mandatory for diagnosis of ruptured pseudoaneurysm? Arch. Gynecol. Obstet., 293(6):1361-1362.

[9]McGonegle, S.J., Dziedzic, T.S., Thomas, J., et al., 2006. Pseudoaneurysm of the uterine artery after an uncomplicated spontaneous vaginal delivery. J. Ultrasound Med., 25(12):1593-1597.

[10]Soyer, P., Fargeaudou, Y., Morel, O., et al., 2008. Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization. Eur. Radiol., 18(6):1181-1187.

[11]Soyer, P., Dohan, A., Dautry, R., et al., 2015. Transcatheter arterial embolization for postpartum hemorrhage: indications, technique, results, and complications. CardioVasc. Intervent. Radiol., 38(5):1068-1081.

[12]Wald, D.A., 2003. Postpartum hemorrhage resulting from uterine artery pseudoaneurysm. J. Emerg. Med., 25(1): 57-60.

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