Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach).
Departments of Obstetrics and Gynecology (Drs. Zilberman, Eisenberg, Yoeli, Soriano, Sivan, and Mashiach).
J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1209-1213. doi: 10.1016/j.jmig.2020.03.010. Epub 2020 Apr 5.
A pseudoaneurysm of the uterine artery or its branches is usually a result of vascular trauma during invasive procedures such as a cesarean section, vaginal delivery, myomectomy, hysterotomy, or dilatation and curettage. A uterine artery pseudoaneurysm rupture is a rare, yet life-threatening event. Deep infiltrating endometriosis usually involves a decrease in symptoms and imaging findings throughout pregnancy, with the notable exception of the phenomenon of decidualization. We present the case of a pregnant woman with a recent diagnosis of endometriosis, who conceived spontaneously and presented with disabling pain at 13 weeks' gestation. She was diagnosed with a left, huge (and rapidly growing) retrocervical endometriosis nodule encompassing a uterine artery pseudoaneurysm. Selective transarterial embolization was performed at 22 weeks' gestation owing to enlargement of the pseudoaneurysm sac, and the pseudoaneurysm was obliterated successfully. The patient was followed intensively throughout the pregnancy and the baby was delivered at term by cesarean section. After delivery, the nodule returned to the pregestational size.
子宫动脉或其分支的假性动脉瘤通常是剖宫产、阴道分娩、子宫肌瘤切除术、子宫切开术或扩张刮宫术等侵入性操作中血管损伤的结果。子宫动脉假性动脉瘤破裂是一种罕见但危及生命的事件。深部浸润性子宫内膜异位症通常在整个怀孕期间伴随着症状和影像学发现的减少，但除了蜕膜化现象外。我们报告了一例近期诊断为子宫内膜异位症的孕妇，她自然受孕，并在 13 周妊娠时出现严重疼痛。她被诊断为左侧巨大（且快速生长）的宫颈后子宫内膜异位症结节，包含一个子宫动脉假性动脉瘤。由于假性动脉瘤囊的增大，在 22 周妊娠时进行了选择性经动脉栓塞，假性动脉瘤被成功闭塞。患者在整个怀孕期间都进行了密切随访，并通过剖宫产足月分娩。分娩后，结节恢复到妊娠前的大小。
