scholarly journals Postpartum Pseudoaneurysm After Cesarean Delivery

2018 ◽  
Vol 35 (2) ◽  
pp. 136-140 ◽  
Author(s):  
Dora DiGiacinto ◽  
Jennifer E. Bagley ◽  
Bradford Gildon ◽  
Gina Cantrell
Keyword(s):  
Cesarean Delivery ◽  
Uterine Artery ◽  
Liver Enzymes ◽  
Vascular Lesion ◽  
Artery Pseudoaneurysm ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
History Of ◽  
Low Platelet Count ◽  
Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is an uncommon vascular lesion that can be life threatening. A ruptured uterine artery pseudoaneurysm can cause acute massive hemorrhaging, creating a true emergency for the postpartum patient. The etiology is more commonly seen with traumatic procedures such as cesarean delivery or curettage. This case report is of a patient with a history of HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome who presented with heavy bleeding after a cesarean delivery. Sonography was primarily used to diagnose the uterine artery pseudoaneurysm. Because of the massive hemorrhaging in this case, a hysterectomy was performed.

scholarly journals Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmet Ozgur Yeniel ◽  
Ahmet Mete Ergenoglu ◽  
Ali Akdemir ◽  
Elmin Eminov ◽  
Fuat Akercan ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Postpartum Hemorrhage ◽  
Uterine Artery ◽  
Angiographic Embolization ◽  
Artery Ligation ◽  
Artery Pseudoaneurysm ◽  
Uterine Artery Ligation ◽  
Life Threatening ◽  
Secondary Postpartum Hemorrhage ◽  
Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is a rare but serious complication of cesarean section. If inadequately treated, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 28-year-old woman who developed secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm and cesarean scar dehiscence after cesarean section. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the surgical procedure of choice for hemodynamically unstable patients when fertility preservation is desired.

Bilateral uterine artery embolization for the management of bilateral uterine artery pseudoaneurysm during puerperium: A case report

2021 ◽  
Vol 10 (1) ◽  
pp. 22-23
Author(s):  
Sally Damra Elnour Mohammed ◽  
Mohammed Khidir Tayfor ◽  
Isra Mutasim Hamad ◽  
Mashaar Osama
Keyword(s):  
Ct Angiography ◽  
Uterine Artery ◽  
Delayed Diagnosis ◽  
Arterial Embolization ◽  
Bleeding Events ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Life Threatening ◽  
The Right ◽  
Uterine Artery Pseudoaneurysm

Background: Uterine artery Pseudoaneurysm is a rare cause of secondary postpartum hemorrhage (PPH) and can develop after various gynecological or obstetric procedures. The delayed diagnosis of such cases often results in life threatening situations. We report a rare case of bilateral uterine artery pseudoaneurysm that led to life threatening secondary PPH after Caesarean section in a patient who had several Caesarean sections before. Case description: A 35 years old multiparus women, who had all her four deliveries by Caesarean sections, presented with recurrent massive attacks of secondary PPH 35ays after her last delivery. Rupture of aneurysm of the uterine artery was suspected and CT angiography showed that the left uterine artery seemed more dilated and was probably the source of the PPH. The bleeding site was successfully tackled by selective arterial embolization. About three weeks later the patient presented again with severe recurrence of PPH. Repeat of CT angiography showed that the source was the right uterine artery this time, which was again selectively embolized. No further bleeding events occurred up to two years follow-up. Conclusion: Rupture of aneurysm of the uterine artery can be a life-threatening condition. Clinical suspicion is essential for a prompt diagnosis Definitive diagnosis can be achieved by CT-angiography. Treatment by selective embolization can effectively stop the bleeding.

scholarly journals Acute renal failure, thrombocytopenia, and elevated liver enzymes after concurrent abuse of alcohol and cocaine

2011 ◽  
Vol 1 (2) ◽  
pp. 35 ◽  
Author(s):  
Alireza Hosseinnezhad ◽  
Rajakrishnan Vijayakrishnan ◽  
Mary Jo S. Farmer
Keyword(s):  
Platelet Count ◽  
Creatine Phosphokinase ◽  
Crack Cocaine ◽  
Liver Enzymes ◽  
Elevated Serum ◽  
Elevated Liver Enzymes ◽  
History Of ◽  
Low Platelet Count ◽  
Laboratory Investigations ◽  
Cocaine Toxicity

Cocaine has been associated with known adverse effects on cardiac, cerebrovascular and pulmonary systems. However, the effect of cocaine on other organs has not been extensively reported. A middle age man presented with abdominal pain and nausea after inhalation of crack cocaine. On admission, he was found to be hypertensive and tachycardic. Physical examination revealed mild abdominal tenderness without rebound. Laboratory investigations were significant for acute kidney failure with elevated serum creatinine (3.72 mg/dL), thrombocytopenia (platelet count 74,000/UL), elevated alanine and aspartate transaminases (ALT 331 U/L; AST 462 U/L) and elevated creatine phosphokinase (CPK 5885 U/L). Urine toxicology screening solely revealed cocaine. A clinical diagnosis of cocaine toxicity was made and patient was admitted to the intensive care unit because of multi organ failure. Despite downward trending of liver enzymes during the hospital course, he continued to have residual renal insufficiency and a low platelet count at the time of discharge. In a patient with history of recent cocaine use presenting with these manifestations, cocaine itself should be considered as a likely cause.

scholarly journals Liver Bleeding Due to HELLP Syndrome Treated With Embolization and Liver Transplantation: A Case Report and Review of the Literature

2021 ◽  
Vol 8 ◽  
Author(s):  
Valentina Messina ◽  
Daniele Dondossola ◽  
Maria Chiara Paleari ◽  
Gianluca Fornoni ◽  
Daniela Tubiolo ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hellp Syndrome ◽  
Multidisciplinary Approach ◽  
Liver Enzymes ◽  
Case Presentation ◽  
Foetal Growth Restriction ◽  
Elevated Liver Enzymes ◽  
Life Threatening ◽  
Low Platelet Count ◽  
Liver Bleeding

Background: Liver bleeding secondary to haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is uncommon, but a life-threatening peripartum condition that needs a prompt multidisciplinary approach.Case Presentation: In this study, we presented a case of 28-year-old pregnant woman, who was presented to the obstetrics department with signs of preeclampsia and foetal growth restriction. An emergency caesarean section was performed, and the patient developed a HELLP syndrome complicated by spontaneous liver rupture. After radiological and surgical procedures, liver failure became evident and liver transplantation was successfully performed. The patient and her daughter are now alive.Conclusions: Despite the rarity of this disease, liver complications due to HELLP syndrome must be properly diagnosed and treated given the gravity of the possible evolution in young women. After diagnosis, the patients must be treated in specialised centres with gynaecological, liver surgery, and transplant skills.

scholarly journals Coronavirus 2019, Thrombocytopenia and HELLP Syndrome: Association or Coincidence?

2020 ◽  
Vol 42 (10) ◽  
pp. 669-671
Author(s):  
Luiz Felipe Bagnatori Braga ◽  
Nelson Sass
Keyword(s):  
Platelet Count ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Present Report ◽  
White Cell Count ◽  
Chain Reaction ◽  
Elevated Liver Enzymes ◽  
History Of ◽  
Low Platelet Count ◽  
Polymerase Chain

AbstractThe present report describes the case of a 31-year-old primigravida, with dichorionic twins at 31 weeks. She presented with history of myalgia, jaundice, and abdominal discomfort. No flu-like symptoms as fever or cough. She was not aware of exposure to COVID-19. Normal blood pressure and O2 saturation. Laboratory tests showed platelet count of 218,000 mm3, alanine aminotransferase (ALT) 558 IU and serum creatinine 2.3 mg/dl. Doppler ultrasound in one twin was compatible with brain sparing. Partial hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome was the hypothesis, and a cesarean section was performed. On day 2, the white-cell count reached 33,730, with decreased consciousness and mild respiratory distress. Tomography revealed both lungs with ground-glass opacities. Swab for COVID-19 polymerase chain reaction (PCR) was positive. Thrombocytopenia in patients with COVID-19 appears to be multifactorial, similar to what occurs in preeclampsia and HELLP syndrome. We assume that the synergism of these pathophysiological mechanisms could accelerate the compromise of maternal conditions and could be a warning to the obstetric practice.

scholarly journals Uterine Artery Pseudoaneurysm in the Setting of Delayed Postpartum Hemorrhage: Successful Treatment with Emergency Arterial Embolization

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Ankur M. Sharma ◽  
Brent E. Burbridge
Keyword(s):  
Postpartum Hemorrhage ◽  
Uterine Artery ◽  
Fluid Collection ◽  
White Blood Count ◽  
Contrast Extravasation ◽  
Selective Embolization ◽  
Artery Pseudoaneurysm ◽  
Dilatation And Curettage ◽  
Elevated Liver Enzymes ◽  
Uterine Artery Pseudoaneurysm

Postpartum hemorrhage is a major cause of maternal mortality. Though uncommon, uterine artery pseudoaneurysm can follow uterine dilatation and curettage (D + C) and needs to be considered in the differential diagnosis. This 30-year-old G1P1 woman presented with right upper quadrant pain and vaginal bleeding. She was afebrile but her white blood count was significantly increased (22.2×109 /L). One week prior, she had undergone a Cesarean delivery which was complicated by hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP), fetal dystocia, and chorioamnionitis. Uterine dilatation and curettage (D & C) and placement of a Bakri intrauterine balloon, performed for suspected retained products of conception, failed to control her postpartum bleeding. The patient wished to have a hysterectomy only as a last resort in order to preserve fertility. Emergency uterine artery angiography revealed a left uterine artery pseudoaneurysm and contrast extravasation. The patient was successfully treated with selective embolization. Computed tomography (CT) later revealed dehiscence of her uterine Cesarean section incision with an intra-abdominal fluid collection. This collection was drained. She also developed disseminated intravascular coagulopathy (DIC) syndrome as well as multiple pulmonary emboli which were both successfully treated. We discuss this unique case of uterine artery pseudoaneurysm with associated uterine dehiscence.

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