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子宫动脉假性动脉瘤破裂导致的产后延迟性出血。

Delayed postpartum hemorrhage resulting from uterine artery pseudoaneurysm rupture.

作者信息

Yun Soon Young, Lee Duk Hee, Cho Kwang Hyun, Lee Hyung Min, Choi Yoon Hee

机构信息

Department of Emergency Medicine, Eulji Medical Center, Eulji University, Seoul, Korea.

出版信息

J Emerg Med. 2012 Jan;42(1):e11-4. doi: 10.1016/j.jemermed.2011.03.005. Epub 2011 Apr 16.

Abstract

BACKGROUND

Rupture of a uterine artery pseudoaneurysm is an uncommon, but life-threatening, cause of postpartum hemorrhage. Cesarean delivery is the most common cause.

OBJECTIVES

Prompt recognition and management are critical in severe vaginal bleeding. A diagnosis of pseudoaneurysm of the uterine artery can be established radiologically, such as with color Doppler ultrasonography and computed tomography. Angiography confirms the diagnosis. This condition can be treated with selective arterial embolization.

CASE REPORTS

We describe three cases of postpartum hemorrhage caused by rupture of pseudoaneurysms of the uterine artery after cesarean section.

CONCLUSION

Uterine arterial pseudoaneurysm rupture is an infrequent, life-threatening cause of delayed postpartum hemorrhage requiring prompt diagnosis and treatment. Early crystalloid infusion and blood transfusion are essential. The initial management and stabilization of uterine artery pseudoaneurysm postpartum hemorrhage requires aggressive resuscitation. Arterial embolization should be considered the definitive treatment.

摘要

背景

子宫动脉假性动脉瘤破裂是产后出血的一种罕见但危及生命的原因。剖宫产是最常见的病因。

目的

在严重阴道出血中,迅速识别和处理至关重要。子宫动脉假性动脉瘤的诊断可通过放射学方法确立,如彩色多普勒超声和计算机断层扫描。血管造影可确诊。这种情况可通过选择性动脉栓塞治疗。

病例报告

我们描述了3例剖宫产术后子宫动脉假性动脉瘤破裂导致产后出血的病例。

结论

子宫动脉假性动脉瘤破裂是产后延迟出血的一种罕见且危及生命的原因,需要迅速诊断和治疗。早期输注晶体液和输血至关重要。产后子宫动脉假性动脉瘤出血的初始处理和稳定需要积极的复苏。应考虑动脉栓塞作为确定性治疗方法。

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