Uterine artery pseudoaneurysm and embolisation during pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234058
Author(s):  
Jared T Roeckner ◽  
Adetola F Louis-Jacques ◽  
Bruce R Zwiebel ◽  
Judette M Louis
Keyword(s):  
Blood Flow ◽  
Uterine Artery ◽  
Thrombin Injection ◽  
Uterine Blood Flow ◽  
Coil Embolisation ◽  
Artery Pseudoaneurysm ◽  
Healthy Young Woman ◽  
Dangerous Condition ◽  
Uterine Artery Pseudoaneurysm ◽  
In Pregnancy

Uterine artery pseudoaneurysm in pregnancy is a dangerous condition as rupture can be catastrophic due to the large volume of uterine blood flow. We present a case of a healthy, young woman with a desired pregnancy at 15 weeks of gestation incidentally discovered to have a pseudoaneurysm of the uterine artery during a routine prenatal ultrasound. She underwent initial thrombin injection followed by endovascular coil embolisation of the left uterine artery and carried the pregnancy to term without further complications.

scholarly journals Uterine artery pseudoaneurysm in the setting of deep endometriosis: an uncommon cause of hemoperitoneum in pregnancy

2017 ◽  
Vol 25 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Zoe Feld ◽  
Tami Rowen ◽  
Andrew Callen ◽  
Ruth Goldstein ◽  
Liina Poder
Keyword(s):  
Uterine Artery ◽  
Deep Endometriosis ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Pseudoaneurysm ◽  
In Pregnancy

scholarly journals [Ca2+]i signaling vs. eNOS expression as determinants of NO output in uterine artery endothelium: relative roles in pregnancy adaptation and reversal by VEGF165

2011 ◽  
Vol 300 (4) ◽  
pp. H1182-H1193 ◽  
Author(s):  
Fu-Xian Yi ◽  
Derek S. Boeldt ◽  
Ronald R. Magness ◽  
Ian M. Bird
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Luteal Phase ◽  
Maximum Rate ◽  
Uterine Artery ◽  
Follicular Phase ◽  
No Production ◽  
Uterine Blood Flow ◽  
Enos Expression ◽  
In Pregnancy

Pregnancy is a time of greatly increased uterine blood flow to meet the needs of the growing fetus. Increased uterine blood flow is also observed in the follicular phase of the ovarian cycle. Simultaneous fura-2 and 4,5-diaminofluoresceine (DAF-2) imaging reveals that cells of the uterine artery endothelium (UA Endo) from follicular phase ewes produce marginally more nitric oxide (NO) in response to ATP than those from luteal phase. However, this is paralleled by changes in NO in response to ionomycin, suggesting this is solely due to higher levels of endothelial nitric oxide synthase (eNOS) protein in the follicular phase. In contrast, UA Endo from pregnant ewes (P-UA Endo) produces substantially more NO (4.62-fold initial maximum rate, 2.56-fold overall NO production) in response to ATP, beyond that attributed to eNOS levels alone (2.07-fold initial maximum rate, 1.93-fold overall with ionomycin). The ATP-stimulated intracellular free calcium concentration ([Ca2+]i) response in individual cells of P-UA Endo comprises an initial peak followed by transient [Ca2+]i bursts that are limited in the luteal phase, not altered in the follicular phase, but are sustained in pregnancy and observed in more cells. Thus pregnancy adaptation of UA Endo NO output occurs beyond the level of eNOS expression and likely through associated [Ca2+]i cell signaling changes. Preeclampsia is a condition of a lack of UA Endo adaptation and poor NO production/vasodilation and is associated with elevated placental VEGF165. While treatment of luteal NP-UA Endo and P-UA Endo with VEGF165 acutely stimulates a very modest [Ca2+]i and NO response, subsequent stimulation of the same vessel with ATP results in a blunted [Ca2+]i and an associated NO response, with P-UA Endo reverting to the response of luteal NP-UA Endo. This demonstrates the importance of adaptation of cell signaling over eNOS expression in pregnancy adaptation of uterine endothelial function and further implicates VEGF in the pathophysiology of preeclampsia.

scholarly journals A Potentially Useful Addition to Predict Spontaneous Resolution of Uterine Artery Pseudoaneurysm: Absence of Diastolic Flow

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Yosuke Baba ◽  
Hironori Takahashi ◽  
Hiroyuki Morisawa ◽  
Daisuke Matsubara ◽  
Kohei Tamura ◽  
...  
Keyword(s):  
Blood Flow ◽  
Uterine Artery ◽  
Pulse Wave ◽  
Swirling Flow ◽  
Transarterial Embolization ◽  
Spontaneous Resolution ◽  
Artery Pseudoaneurysm ◽  
Diastolic Flow ◽  
Current Bleeding ◽  
Uterine Artery Pseudoaneurysm

Pregnancy-associated uterine artery pseudoaneurysm (UAP) usually requires transarterial embolization (TAE) irrespective of the presence/absence of current bleeding. Some UAP cases spontaneously resolve without TAE; however, such UAP is not well characterized. Here, we suggest that Pulse Wave Doppler may become an addition to predict its spontaneous resolution. A woman underwent 1st-trimester vaginal termination. Vaginal bleeding repeated and, 36 days later, an intrauterine low-echoic mass (24 mm) with swirling blood flow and arterial waveforms (Pulse Wave Doppler) and an enhanced intrauterine sac-like structure without current extravasation were observed, leading to the diagnosis of UAP. Subsequently, the low-echoic mass mostly disappeared but the swirling flow was still observed, with Pulse Wave Doppler revealing arterial flow but the absence of diastolic flow. Finally, the flow disappeared and UAP resolved. This observation reconfirmed spontaneous UAP resolution. The “absent diastolic flow,” possibly indicative of decreased intrasac blood flow, may be a candidate for predicting UAP resolution.

scholarly journals Massive subchorionic haemorrhage: a rare case report associated with secondary PPH due to uterine artery pseudoaneurysm

2017 ◽  
Vol 6 (10) ◽  
pp. 4723
Author(s):  
J. Arumaikannu ◽  
S. Usha Rani ◽  
T. S. Aarifa Thasleem
Keyword(s):  
Rare Case ◽  
Uterine Artery ◽  
Post Partum ◽  
Uterine Wall ◽  
Cervical Canal ◽  
Artery Pseudoaneurysm ◽  
Rare Case Report ◽  
Chorionic Membrane ◽  
Uterine Artery Pseudoaneurysm ◽  
In Pregnancy

Massive subchorionic hemorrhage is a rare but serious condition in pregnancy in which a large amount of blood, mainly maternal collects between the uterine wall and the chorionic membrane and may leak through the cervical canal. Although many associations have been reported, an underlying etiology has not been elucidated. Association of massive subchorionic hemorrhage with thrombophilias have been reported in few articles. We are reporting a case of massive subchorionic hemorrhage presented at 13 weeks of gestation associated with secondary post-partum hemorrhage due to uterine artery pseudoaneurysm.

scholarly journals Estrogen Receptors and Estrogen-Induced Uterine Vasodilation in Pregnancy

2020 ◽  
Vol 21 (12) ◽  
pp. 4349 ◽  
Author(s):  
Jin Bai ◽  
Qian-Rong Qi ◽  
Yan Li ◽  
Robert Day ◽  
Josh Makhoul ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Uterine Artery ◽  
Normal Pregnancy ◽  
Uterine Blood Flow ◽  
Growth And Survival ◽  
Respiratory Gases ◽  
G Protein Coupled ◽  
In Pregnancy

Normal pregnancy is associated with dramatic increases in uterine blood flow to facilitate the bidirectional maternal–fetal exchanges of respiratory gases and to provide sole nutrient support for fetal growth and survival. The mechanism(s) underlying pregnancy-associated uterine vasodilation remain incompletely understood, but this is associated with elevated estrogens, which stimulate specific estrogen receptor (ER)-dependent vasodilator production in the uterine artery (UA). The classical ERs (ERα and ERβ) and the plasma-bound G protein-coupled ER (GPR30/GPER) are expressed in UA endothelial cells and smooth muscle cells, mediating the vasodilatory effects of estrogens through genomic and/or nongenomic pathways that are likely epigenetically modified. The activation of these three ERs by estrogens enhances the endothelial production of nitric oxide (NO), which has been shown to play a key role in uterine vasodilation during pregnancy. However, the local blockade of NO biosynthesis only partially attenuates estrogen-induced and pregnancy-associated uterine vasodilation, suggesting that mechanisms other than NO exist to mediate uterine vasodilation. In this review, we summarize the literature on the role of NO in ER-mediated mechanisms controlling estrogen-induced and pregnancy-associated uterine vasodilation and our recent work on a “new” UA vasodilator hydrogen sulfide (H2S) that has dramatically changed our view of how estrogens regulate uterine vasodilation in pregnancy.

scholarly journals Postpartum hemorrhage caused by uterine artery pseudoaneurysm: A case report

2021 ◽  
Vol 29 ◽  
pp. e00286
Author(s):  
Danielle Glassman ◽  
Ruchi Karsalia ◽  
Issam Moubarak ◽  
Mark V. Sauer ◽  
Ashima Singla
Keyword(s):  
Case Report ◽  
Postpartum Hemorrhage ◽  
Uterine Artery ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Pseudoaneurysm

scholarly journals Overview of Neo-Vascular Lesions after Delivery or Miscarriage

2021 ◽  
Vol 10 (5) ◽  
pp. 1084
Author(s):  
Yuji Shiina
Keyword(s):  
Arteriovenous Malformations ◽  
Uterine Artery ◽  
Spontaneous Regression ◽  
Vascular Diseases ◽  
Vascular Lesions ◽  
Artery Pseudoaneurysm ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Uterine Artery Pseudoaneurysm ◽  
Retained Products

The concept of intrauterine neo-vascular lesions after pregnancy, initially called placental polyps, has changed gradually. Now, based on diagnostic imaging, such lesions are defined as retained products of conception (RPOC) with vascularization. The lesions appear after delivery or miscarriage, and they are accompanied by frequent abundant vascularization in the myometrium attached to the remnant. Many of these vascular lesions have been reported to resolve spontaneously within a few months. Acquired arteriovenous malformations (AVMs) must be considered in the differential diagnosis of RPOC with vascularization. AVMs are errors of morphogenesis. The lesions start to be constructed at the time of placenta formation. These lesions do not show spontaneous regression. Although these two lesions are recognized as neo-vascular lesions, neo-vascular lesions on imaging may represent conditions other than these two lesions (e.g., peritrophoblastic flow, uterine artery pseudoaneurysm, and villous-derived malignancies). Detecting vasculature at the placenta–myometrium interface and classifying vascular diseases according to hemodynamics in the remnant would facilitate the development of specific treatments.

Uterine Artery Pseudoaneurysm after Cesarean Section: Case Report and Literature Review

2010 ◽  
Vol 17 (6) ◽  
pp. 687-691 ◽  
Author(s):  
Wataru Isono ◽  
Ryo Tsutsumi ◽  
Osamu Wada-Hiraike ◽  
Akihisa Fujimoto ◽  
Yutaka Osuga ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Cesarean Section ◽  
Uterine Artery ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Pseudoaneurysm
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