Preventing Thrombotic Events in a Case of Postpartum Ovarian Artery Aneurysm Rupture: Clinical Challenges and Management Approaches Publisher



Rasti S¹ ; Zarean E² ; Jafarpisheh MS¹ ; Aria A³ Show Affiliations
Source: Journal of Surgical Case Reports Published:2023

Abstract

Ovarian artery aneurysm is a rare asymptomatic condition usually diagnosed when it ruptures. It causes massive bleeding, often in the peripartum period of multiparous women, who are already at an increased risk for thromboembolic events. Balancing the bleeding risk against the thrombotic complications remains unexplored in such cases. A 35-year-old woman presented with hemorrhagic shock 3 days after delivering her seventh healthy child. During the emergent exploratory laparotomy, she responded well to the blood transfusion; the stable retroperitoneal hematoma indicated no need to explore it. A subsequent episode of hemodynamic instability necessitated another laparotomy, during which the hematoma was evacuated and both ovarian arteries were ligated. Shortly thereafter, the patient suffered a pulmonary embolism (PE). In multiparous patients presenting with peripartum retroperitoneal hematoma and hemorrhagic shock, exploring the hematoma and ligating the ovarian and uterine arteries may reduce the risk of PE or the need for reoperation. © The Author(s) 2023. Published by Oxford University Press and JSCR Publishing Ltd.