VP06.06: Uterine artery pseudoaneurysm: rare complication of Caesarean section

The incidence of uterine pseudoaneurysms is rare. The physiopathological mechanism of their occurrence is most often traumatic. The context of discovery is most often postpartum following a Caesarean section. We report the case of a 40-year-old primiparous patient who consulted at day 10 postpartum by Caesarean section for metrorrhagia of moderate severity. The examination showed a pulse rate of 100 bpm, a correct blood pressure, ecchymotic patches in front of the incision scar and on the inner side of the thighs, a minimal endo-uterine bleeding and a soft abdomen. Pelvic ultrasound showed at the right side of the uterus a 40 mm Doppler vascularised anechoic image suggesting a false uterine artery aneurysm. Pelvic CT scan found a right latero-uterine formation partially filling at arterial time confirming the diagnosis. An anemia of 8.5 g/dl was observed in the biology. Uterine artery embolisation was not available, the patient had an emergency surgical ligation of the right hypogastric artery, with blood transfusion. The evolution was marked by the drying up of metrorrhagia and regression of the ecchymotic patches. Pseudoaneurysm is a rare and serious postpartum complication. This condition should be considered in the presence of persistent and abundant postpartum metrorrhagia with uterine trauma. Doppler ultrasound suspects the diagnosis and CT scan confirms it. Uterine artery embolisation is the gold standard for the treatment. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.