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自然阴道分娩后阴部内动脉动脉瘤破裂:产后出血的罕见原因。

Rupture of internal pudendal artery aneurysm following spontaneous vaginal delivery: An uncommon cause of post-partum bleeding.

作者信息

Martingano Daniel, Martingano Francis X, Ruggiero-DeCarlo Rosemary

机构信息

Department of Obstetrics & Gynecology, NYU Lutheran Medical Center, Brooklyn, NY, USA.

出版信息

Obstet Med. 2016 Sep;9(3):138-41. doi: 10.1177/1753495X16647618. Epub 2016 May 10.

Abstract

Pregnancy-related rupture of an arterial aneurysm is an unusual occurrence associated with increased risk of morbidity and mortality. Various pregnancy-related physiologic changes appear to make pregnancy a high-risk situation for rupture of either preexisting arterial aneurysms or those that develop throughout the course of pregnancy. Splenic artery aneurysms are the most common (60%), followed by hepatic (20%), superior mesenteric (5.9%), celiac (4%), ovarian, uterine, and renal (<2%) artery. Even rarer are aneurysms involving the internal iliac artery and its branches, to which there is only one published case report. In this report, we present a case of a 34-year-old pregnant gravida1 para0 who, following a normal vaginal delivery, had a severe rupture of the right internal pudendal artery and subsequently developed a massive hematoma which ultimately required embolization treatment.

摘要

妊娠相关的动脉动脉瘤破裂是一种不常见的情况,与发病率和死亡率增加相关。各种与妊娠相关的生理变化似乎使妊娠成为已存在的动脉动脉瘤或在妊娠过程中形成的动脉瘤破裂的高风险情况。脾动脉瘤最常见(60%),其次是肝动脉瘤(20%)、肠系膜上动脉瘤(5.9%)、腹腔动脉瘤(4%)、卵巢、子宫和肾动脉瘤(<2%)。涉及髂内动脉及其分支的动脉瘤更为罕见,仅有一篇病例报告。在本报告中,我们介绍了一例34岁的初产妇,在正常阴道分娩后,右侧阴部内动脉发生严重破裂,随后形成巨大血肿,最终需要进行栓塞治疗。

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