PDF(Pubmed)
Abstract：
Pseudoaneurysm formation often occurs when there is inadequate sealing at an arterial puncture site. We present the case of a 27-year-old primigravida with rheumatic heart disease and a history of mitral valve replacement on anticoagulants who experienced recurrent episodes of postpartum hemorrhage (PPH). Despite conservative management and adjustments to anticoagulant therapy, the bleeding persisted. Further investigations revealed a small pseudoaneurysm originating from the left uterine artery. Bilateral uterine artery embolization (UAE) using polyvinyl alcohol particles was successfully performed. The patient\'s condition improved, and she was discharged on a carefully regulated medication regimen. This case highlights the importance of considering rare causes of PPH in high-risk patients, such as uterine artery pseudoaneurysm. Anticoagulants could be a potential contributor of its spontaneous rupture. Prompt diagnosis and appropriate intervention, such as UAE, can effectively manage PPH and prevent adverse outcomes.
摘要：
假性动脉瘤形成通常发生在动脉穿刺部位密封不足时。我们介绍了一例27岁的患有风湿性心脏病的primigravida，并有使用抗凝血剂的二尖瓣置换史，经历了产后出血（PPH）的反复发作。尽管保守的管理和抗凝治疗的调整，出血持续。进一步的调查显示，一个小的假性动脉瘤起源于左子宫动脉。成功进行了使用聚乙烯醇颗粒的双侧子宫动脉栓塞（UAE）。病人的病情好转,她在精心监管的药物治疗方案下出院。这个案例强调了在高危患者中考虑PPH的罕见原因的重要性。如子宫动脉假性动脉瘤。抗凝剂可能是其自发破裂的潜在原因。及时诊断和适当干预，比如阿联酋，可以有效地管理PPH并预防不良后果。
