剖宫产术后子宫动脉假性动脉瘤致晚期产后出血1例分析并文献复习

Delayed Postpartum Hemorrhage Resulting from Uterine Artery Pseudo Aneurysm after Cesarean Section: A Case Report and Literature Review

摘要: 作为产科严重并发症之一，产后出血(postpartum hemorrhage)仍然是世界上大多数国家孕产妇死亡的首要原因。子宫动脉假性动脉瘤(UAP)是一种较为罕见的血管和血流异常性并发症，可以继发于各种妇产科操作，是剖宫产术后晚期产后出血原因之一，可因阴道反复大量流血而威胁患者生命。由于本病发病率低，且临床表现缺乏特异性，故极容易被误诊和漏诊，从而导致严重不良事件的发生。本文报告青大附院产科收治的1例剖宫产术后并发子宫动脉假性动脉瘤，致晚期产后出血的患者的诊疗经过，探讨可行的诊疗策略及规范诊疗思路，以期降低此类疾病不良结局的发生率，现结合文献复习报告如下。

Abstract: As one of the serious complications in obstetrics, postpartum hemorrhage remains the leading cause of maternal mortality in most countries around the world. Uterine artery pseudo aneurysm (UAP) is a rare complication of abnormal blood vessels and blood flow, which can be secondary to various obstetrics and gynecology operations. It is one of the causes of late postpartum hemorrhage after cesarean section, which can threaten the life of patients due to repeated vaginal bleeding. Due to the low incidence of this disease and the lack of specificity in clinical manifestations, it is very easy to be misdiagnosed and under diagnosed, which leads to the occurrence of serious adverse events. This paper reports the diagnosis and treatment of a case of uterine artery pseudo aneurysm complicated by cesarean section and resulting in late postpartum hemorrhage admitted to the obstetrics department of the Affiliated Hospital of Qingdao University. Feasible diagnosis and treatment strategies and standardized diagnosis and treatment ideas are discussed in order to reduce the incidence of adverse outcomes of such diseases. The following report is reviewed based on literature.