Development of pseudoaneurysm in cesarean section scar pregnancy

a case report and literature review

Shunki Kiyokawa, Tatsuyuki Chiyoda, Kazunori Ueno, Keiko Saotome, Seon Hye Kim, Sakura Nakada

Research output: Contribution to journalArticle

Abstract

Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. It is becoming more common, but it can lead to uterine rupture and severe hemorrhage. Here, we report a case of a 37-year-old woman with CSP complicated with pseudoaneurysm. The pseudoaneurysm emerged following focal injection of methotrexate (MTX) and potassium chloride with systemic MTX treatment. Due to a risk of sudden bleeding, uterine artery embolization (UAE) was recommended, but the patient hoped to avoid this if possible. Because the serum human chorionic gonadotropin level and the gestational sac were still persistent, dilation and curettage were performed with interventional radiologists on standby. Severe hemorrhage occurred and continued during the procedure, which necessitated emergent UAE. We reviewed six CSP case reports with vascular abnormalities, and all of them necessitated UAE, surgical excision, or hysterectomy. In the case of CSP combined with pseudoaneurysm, treatment should be planned carefully considering the risk of massive hemorrhage.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalJournal of Medical Ultrasonics
DOIs
Publication statusAccepted/In press - 2017 Nov 16

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False Aneurysm
Uterine Artery Embolization
Cesarean Section
Cicatrix
Hemorrhage
Pregnancy
Methotrexate
Gestational Sac
Uterine Rupture
Potassium Chloride
Curettage
Ectopic Pregnancy
Chorionic Gonadotropin
Hysterectomy
Blood Vessels
Dilatation
Injections
Therapeutics
Serum

Keywords

  • Arterio-venous malformation
  • Cesarean section
  • Pregnancy
  • Pseudoaneurysm
  • Uterine artery embolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Development of pseudoaneurysm in cesarean section scar pregnancy : a case report and literature review. / Kiyokawa, Shunki; Chiyoda, Tatsuyuki; Ueno, Kazunori; Saotome, Keiko; Kim, Seon Hye; Nakada, Sakura.

In: Journal of Medical Ultrasonics, 16.11.2017, p. 1-6.

Research output: Contribution to journalArticle

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