Case Reports in Obstetrics and Gynecology
Volume 2018, Article ID 2158248, 3 pages
https://doi.org/10.1155/2018/2158248
A Potentially Useful Addition to Predict Spontaneous Resolution of Uterine Artery Pseudoaneurysm: Absence of Diastolic Flow
1Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan
2Department of Pediatrics, Jichi Medical University, Tochigi, Japan
Correspondence should be addressed to Shigeki Matsubara; pj.ca.ihcij@ihsustam
Received 5 October 2017; Accepted 30 January 2018; Published 20 March 2018
Academic Editor: Irene Hoesli
Copyright © 2018 Yosuke Baba et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Pregnancy-associated uterine artery pseudoaneurysm (UAP) usually requires transarterial embolization (TAE) irrespective of the presence/absence of current bleeding. Some UAP cases spontaneously resolve without TAE; however, such UAP is not well characterized. Here, we suggest that Pulse Wave Doppler may become an addition to predict its spontaneous resolution. A woman underwent 1st-trimester vaginal termination. Vaginal bleeding repeated and, 36 days later, an intrauterine low-echoic mass (24 mm) with swirling blood flow and arterial waveforms (Pulse Wave Doppler) and an enhanced intrauterine sac-like structure without current extravasation were observed, leading to the diagnosis of UAP. Subsequently, the low-echoic mass mostly disappeared but the swirling flow was still observed, with Pulse Wave Doppler revealing arterial flow but the absence of diastolic flow. Finally, the flow disappeared and UAP resolved. This observation reconfirmed spontaneous UAP resolution. The “absent diastolic flow,” possibly indicative of decreased intrasac blood flow, may be a candidate for predicting UAP resolution.