Temporary bilateral uterine artery occlusion in the control of hemorrhage: A case report and review of literature

Abstract

BACKGROUND

Intramural pregnancy is rare, with an unclear etiology and pathophysiology. Surgical, medical, and expectant management options are available for this condition. However, most reported cases are managed surgically. Despite the risks of massive intraoperative bleeding and acute and long-term complications, uterine artery embolization is often selected. Temporary occlusion of the bilateral uterine arteries during surgery is associated with fewer complications.

CASE SUMMARY

We reported the case of a patient who was diagnosed with intramural pregnancy approximately one month after medical abortion. We performed laparoscopic resection with hysteroscopy. Since the lesion had abundant blood flow, we temporarily blocked the bilateral uterine arteries to prevent massive intraoperative bleeding. The surgical process went smoothly. The postoperative course was uneventful.

CONCLUSION

Temporary occlusion of the bilateral uterine arteries in the treatment of intramural pregnancy may prevent excessive uterine bleeding during surgery.

Keywords: Intramural pregnancy; Hysteroscopy; Laparoscopic surgery; Uterine artery temporary occlusion; Case report

Core Tip: Intramural pregnancy is rare. There are few reports on temporary uterine artery occlusion for the treatment of intramural pregnancy. Here, we review studies on intramural pregnancy and report bilateral uterine artery occlusion during laparoscopic surgery and hysteroscopy for intramural pregnancy. The surgical process and postoperative course were uneventful.