Postpartum haemorrhage requiring embolisation of a hypertrophied round ligament artery

• Type of Material: Article
• Authors: Alexander Dabrowiecki, Emory University; Janice Newsome, Emory University; Zachary Bercu, Emory University; Jonathan Martin, Emory University
• Language: English
• Date: 2019-08-01
• Publisher: BMJ Specialist Journals
• Publication Version: Final Published Version
• Copyright Statement: © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bcr-2019-230071
• Title of Journal or Parent Work: BMJ Case Reports
• Volume: 12
• Issue: 8
• Start Page: e230071
• End Page: e230071
• Grant/Funding Information: The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
• Keywords: Postpartum Hemorrhage; Hypertrophy; Obstetrics And Gynaecology; Interventional Radiology; Round Ligament of Uterus; Female; Pregnancy; Adult; Humans; Uterine Artery Embolization; Uterine Artery; Radiology
• Research Categories: Health Sciences, Radiology; Health Sciences, Medicine and Surgery

Abstract

A gravida 4 para 1021, 41-year-old woman postcaesarean section at 39 weeks and 1 day with clinically significant haemorrhage required embolisation of unique uterine arterial collaterals. She had persistent haemorrhage after initial bilateral uterine artery embolisation, and on further investigation she was found to have a hypertrophied right round ligament artery. Once successful embolisation of this abnormal right round ligament artery was completed using a combination of Gelfoam and coils, haemostasis was achieved. She had rapid clinical improvement, no complications and no further admissions on postprocedural follow-up over a year and a half later.