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Secondary postpartum hemorrhage due to uterine artery pseudoaneurysm rupture in von Willebrand disease
Author(s) -
Shimizu Misao,
Kondoh Eiji,
Ueda Masashi,
Kakui Kazuyo,
Tatsumi Keiji,
Konishi Ikuo
Publication year - 2011
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2011.01674.x
Subject(s) - medicine , pseudoaneurysm , uterine artery , vaginal bleeding , von willebrand disease , angiography , hemoperitoneum , surgery , radiology , von willebrand factor , aneurysm , pregnancy , gestation , platelet , biology , genetics
We here report a case of a 33‐year‐old woman who experienced secondary postpartum hemorrhage (PPH) due to uterine artery pseudoaneurysm rupture. She had intrauterine balloon tamponade for unexplained primary PPH after spontaneous vaginal delivery, and subsequent angiography showed no abnormal contrast extravasation. However, profuse vaginal bleeding occurred 22 days postpartum. Color Doppler ultrasonography demonstrated an anechoic mass with turbulent flow in the lower uterine segment, corresponding to uterine artery pseudoaneurysm. She was successfully treated with selective uterine arterial embolization. Decreased levels of von Willebrand factor and factor VIII led to the diagnosis of von Willebrand disease. When it is determined that a patient has unexplained PPH or uterine artery pseudoaneurysm, a high index of suspicion and further investigation for underlying bleeding disorders is warranted.