Abstract：
BACKGROUND: Uterine artery pseudoaneurysm (UAP) is a rare but potentially life-threatening cause of hemorrhage. Nonetheless, its knowledge could be insufficient among obstetricians, gynecologists, and radiologists. We aimed to clarify the clinical characteristics, management, and outcomes of UAP.
METHODS: We retrospectively analyzed nine female patients diagnosed with UAP at our institute between 2013 and 2020.
RESULTS: Seven cases presented with a history of traumatic surgery including cesarean section, dilation and curettage, laparoscopic myomectomy, and cervical conization. Two cases occurred after spontaneous vaginal delivery and second-trimester pregnancy termination. The main symptom was heavy/massive/prolonged vaginal bleeding. All patients were first evaluated by color Doppler ultrasonography and three cases were confirmed by magnetic resonance imaging. Severn patients underwent transarterial embolization (TAE) of the uterine arteries, and two were managed conservatively. All patients had good outcomes.
CONCLUSIONS: UAP can develop after traumatic pelvic operations and non-traumatic delivery/abortion. It may be more common than previously considered. The risk of rupture may be correlated with multiple factors other than the mass size. TAE of the uterine artery could be an effective management strategy for ruptured UAP. However, some cases can resolve spontaneously without TAE, suggesting that conservative management can be employed in some women.
METHODS: We retrospectively analyzed nine female patients diagnosed with UAP at our institute between 2013 and 2020.
RESULTS: Seven cases presented with a history of traumatic surgery including cesarean section, dilation and curettage, laparoscopic myomectomy, and cervical conization. Two cases occurred after spontaneous vaginal delivery and second-trimester pregnancy termination. The main symptom was heavy/massive/prolonged vaginal bleeding. All patients were first evaluated by color Doppler ultrasonography and three cases were confirmed by magnetic resonance imaging. Severn patients underwent transarterial embolization (TAE) of the uterine arteries, and two were managed conservatively. All patients had good outcomes.
CONCLUSIONS: UAP can develop after traumatic pelvic operations and non-traumatic delivery/abortion. It may be more common than previously considered. The risk of rupture may be correlated with multiple factors other than the mass size. TAE of the uterine artery could be an effective management strategy for ruptured UAP. However, some cases can resolve spontaneously without TAE, suggesting that conservative management can be employed in some women.
摘要：
背景：子宫动脉假性动脉瘤（UAP）是一种罕见但可能危及生命的出血原因。尽管如此，它的知识可能在产科医生中不足，妇科医生,和放射科医生。我们旨在阐明临床特征，管理,和UAP的结果。
方法：我们回顾性分析了2013年至2020年在我们研究所诊断为UAP的9名女性患者。
结果：7例有包括剖宫产在内的外伤手术史，扩张和刮宫，腹腔镜子宫肌瘤切除术,宫颈锥切术。2例发生在自然阴道分娩和中期妊娠终止后。主要症状是严重/大量/长时间的阴道出血。所有患者均首先通过彩色多普勒超声检查进行评估，3例经磁共振成像证实。Severn患者接受了子宫动脉的经动脉栓塞（TAE），还有两个是保守管理的。所有患者均有良好的预后。
结论：UAP可在创伤性盆腔手术和非创伤性分娩/流产后发生。它可能比以前认为的更常见。破裂的风险可能与质量大小以外的多个因素相关。子宫动脉TAE可能是UAP破裂的有效治疗策略。然而,有些病例可以在没有TAE的情况下自发消退，这表明一些女性可以采用保守的管理。
方法：我们回顾性分析了2013年至2020年在我们研究所诊断为UAP的9名女性患者。
结果：7例有包括剖宫产在内的外伤手术史，扩张和刮宫，腹腔镜子宫肌瘤切除术,宫颈锥切术。2例发生在自然阴道分娩和中期妊娠终止后。主要症状是严重/大量/长时间的阴道出血。所有患者均首先通过彩色多普勒超声检查进行评估，3例经磁共振成像证实。Severn患者接受了子宫动脉的经动脉栓塞（TAE），还有两个是保守管理的。所有患者均有良好的预后。
结论：UAP可在创伤性盆腔手术和非创伤性分娩/流产后发生。它可能比以前认为的更常见。破裂的风险可能与质量大小以外的多个因素相关。子宫动脉TAE可能是UAP破裂的有效治疗策略。然而,有些病例可以在没有TAE的情况下自发消退，这表明一些女性可以采用保守的管理。
