Secondary Postpartum Hemorrhage due to Spontaneous Uterine Artery Rupture after Normal Vaginal Delivery Managed by Selective Arterial Embolization

Mili Thakur; Henry O. Adekola; Radwan Asaad; Bernard Gonik

doi:10.1055/s-0036-1597623

American Journal of Perinatology Reports, Table of Contents

AJP Rep 2016; 06(04): e442-e444
DOI: 10.1055/s-0036-1597623

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Secondary Postpartum Hemorrhage due to Spontaneous Uterine Artery Rupture after Normal Vaginal Delivery Managed by Selective Arterial Embolization

Authors

Mili Thakur

¹Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan

²Division of Genetic and Metabolic Disorders, Department of Pediatrics and Center for Molecular Medicine and Genetics, Wayne State University/Detroit Medical Center, Detroit, Michigan
Henry O. Adekola

³Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, Michigan
Radwan Asaad

¹Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan
Bernard Gonik

¹Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan

Abstract

Secondary postpartum hemorrhage due to an intraperitoneal bleed following a vaginal delivery is extremely rare. We present a case of spontaneous rupture of the uterine artery following a normal vaginal delivery with a delayed presentation, which resulted in significant morbidity. This case discusses the presentation and management of this rare obstetrical emergency. The report also discusses the role of selective arterial embolization in management of secondary postpartum hemorrhage.

Keywords

secondary postpartum hemorrhage - spontaneous uterine artery rupture - uterine artery embolization - intraperitoneal bleeding - hemorrhagic shock

Full Text

References

References
1 Hoveyda F, MacKenzie IZ. Secondary postpartum haemorrhage: incidence, morbidity and current management. BJOG 2001; 108 (9) 927-930
2 Banaś T, Boryczko M, Durzyńska-Urbaniec J. [Intraperitoneal hemorrhage due to the rupture of right ovarian artery in the second day of puerperium] in Polish]. Ginekol Pol 2004; 75 (9) 729-732
3 Becker R, Kowalsky BL, Hatzmann W. [Rupture of the uterine artery after spontaneous delivery with unusual course in childbed] [in German]. Z Geburtshilfe Neonatol 2002; 206 (3) 107-113
4 Duhan N, Sangwan N, Rajotia N, Kadian YS, Singla SL. Spontaneous uterine artery rupture at delivery. J Obstet Gynaecol India 2013; 63 (1) 72-73
5 Asokan S, Chew EK, Ng KY, Thanaletchimy N, Asmiati A, Kong NM. Post partum splenic artery aneurysm rupture. J Obstet Gynaecol Res 2000; 26 (3) 199-201
6 Fieni S, Berretta R, Merisio C, Melpignano M, Gramellini D. Retzius' space haematoma after spontaneous delivery: a case report. . Acta Biomed 2005; 76 (3) 175-177
7 Morel O, Malartic C, Muhlstein J , et al. Pelvic arterial ligations for severe post-partum hemorrhage. Indications and techniques. J Visc Surg 2011; 148 (2) e95-e102
8 Ganguli S, Stecker MS, Pyne D, Baum RA, Fan CM. Uterine artery embolization in the treatment of postpartum uterine hemorrhage. J Vasc Interv Radiol 2011; 22 (2) 169-176
9 Ginsburg KA, Valdes C, Schnider G. Spontaneous utero-ovarian vessel rupture during pregnancy: three case reports and a review of the literature. Obstet Gynecol 1987; 69 (3 Pt 2): 474-476
10 Ravina JH, Vigneron NC, Aymard A, Le Dref O, Merland JJ. Pregnancy after embolization of uterine myoma: report of 12 cases. Fertil Steril 2000; 73 (6) 1241-1243
11 Deux JF, Bazot M, Le Blanche AF , et al. Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage?. AJR Am J Roentgenol 2001; 177 (1) 145-149