Treatment of uterine artery (pseudo)aneurysm during pregnancy: A case report and review of the literature.

ABSTRACT

PURPOSE: To describe the management of uterine artery (pseudo)aneurysm, ruptured or unruptured, during pregnancy. METHODS: After reporting a case about this rare pathology, a review of the literature was performed. The search was applied to PubMed databases. RESULTS: A total of eighteen articles met the inclusion criteria. Eighteen patients were reported. Eight (44.4 %) patients didn't have prior medical or surgical history. Fifteen (83.3 %) beneficed interventional radiology method during pregnancy including two cases (13.3 %) with repeated embolization because of recanalization of the (pseudo)aneurysm. Nine patients (50 %) beneficed a planned cesarean between 34 and 39 weeks of gestation. One (15.8 %) patient was diagnosed with fetal death before treatment of the uterine artery (pseudo)aneurysm. CONCLUSION: The decision to proceed to the treatment of the (pseudo)aneurysm must consider several factors, associated or not with a good fetal vitality and a hemodynamically stable patient. Embolization appears to be the method of choice. Mode of delivery and term remain not clear and contraindication of expulsive efforts in case of a uterine artery (pseudo)aneurysm merit further investigations.