American Journal of Perinatology, Table of Contents Am J Perinatol 2002; 19(5): 241-246DOI: 10.1055/s-2002-33083 Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662 Unusual Pregnancy-Related Vascular Emergency Giuseppe Cardia1 , Domenico Iusco1 , Rocco Melino2 , Vincenzo Neri2 , Michele Nacchiero1 1Dipartimento per l'Applicazione in Chirurgia delle Tecniche Innovative, Cattedra di Chirurgia Generale III, Università degli Studi Bari, Capurso (Bari), Italy and 2Chirurgia Generale Universitaria, Università degli Studi Foggia, Foggia, Italy Recommend Article Abstract Buy Article ABSTRACT Although rare, aneurysms are well-known pregnancy-related vascular diseases. They are influenced by hormonal, mechanical, and genetic factors and may be associated with high incidence of maternal and fetal mortality. We present a case of a pregnancy-related common iliac aneurysm, ruptured 5 days after delivery. The source of bleeding was recognized during the second emergency laparotomy for hemoperitoneum and retroperitoneal hematoma. The treatment consisted of excision and substitution of the common iliac artery (totally involved) by an autologous saphenous vein graft. The outcome for the patient was good. We underline that the only way to avoid a fatal event is to know and to think about this rare but very important complication that may occur during pregnancy or shortly after delivery. KEYWORDS Aneurysm - pregnancy complication - retroperitoneum Full Text References REFERENCES 1 Barrett J M, Van Hooydonk E J, Boehm F H. Pregnancy-related rupture of arterial aneurysms. Obstet Gynecol Surv . 1982; 37 557-566 2 Wiliams G M, Gott V L, Brawley R K. Aortic disease associated with pregnancy. J Vasc Surg . 1988; 8 470 3 Togni M, Amann F W, Follath F. Spontaneous multivessel coronary artery dissection in a pregnant woman treated successfully with implantation. Am J Med . 1999; 107 407-408 4 Cardia G, Loverro G, Nappi E, Strada L, Selvaggi L. Uterine artery aneurysm rupture in pregnancy. Obstet Gynecol . 1994; 14 165 5 Belfort M A, Simon T, Kirshon B, Howell J F. Ruptured ovarian artery aneurysm complicating a term vaginal delivery. South Med J . 1993; 86 1073-1074 6 Nolte J F, Rutherford R B, Nawaz S, Rosemberg A, Speers W C, Krupsky W C. Arterial dissections associated with pregnancy. J Vasc Surg . 1995; 21 515-520 7 Benedetti F, Valentini J R, Gossetti B. La patologia aneurismatica nella donna. Patol vasc Bologna . 1987; 305-313 8 Perrot-Applanat M. Effect of estrogens on vascular proliferation. Therapie . 1999; 54 333-337 9 Konishi Y, Tatsuta N, Kumada K. Dissecting aneurysm during pregnancy and the puerperium. Jpn Circ J . 1980; 44 726-733 10 Guillem P, Bondue X, Chambon J P, Lemaitre L, Bounona F. Spontaneous retroperitoneal hematoma from rupture of an aneurysm of the ovarian artery following delivery. Ann Vasc Surg . 1999; 13 445-448 11 Bell P RF. Surgery for iliac aneurysm. In: Greenhalg RM, Mannicck JA, eds. The Cause and Management of Aneurysms Philadelphia: W.B. Saunders 1990: 303-309 12 Richardson J W, Greenfield L J. Natural history and management of iliac aneurysms. J Vasc Surg . 1988; 8 165-171 13 Bolin T, Lund K, Skan T. Isolated aneurysms of the iliac artery: what are the chances of rupture?. Eur J Vasc Surg . 1988; 2 214-215 14 Zimmer P W, Raker E J, Quigley T M. Isolated hypogastric artery aneurysms. Ann Vasc Surg . 1999; 13 545 15 Davidsen M B, Madsen P V, Wilken-Jensen C. True aneurysm of the uterine artery. Eur J Surg . 1995; 161 775-776
