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Acta clinica Croatica, Vol. 57. No. 1., 2018.

Other

https://doi.org/10.20471/acc.2018.57.01.20

Spontaneous Rupture of Internal Iliac Artery in Pregnancy: Case Report

Dražan Butorac ; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Ivka Djaković orcid id orcid.org/0000-0003-2275-6389 ; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Vesna Košec ; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
Miroslav Kopjar ; Dubrovnik International University, Dubrovnik, Croatia
Krunoslav Kuna ; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia

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Abstract

Rupture of the internal iliac artery is a rare complication in pregnancy that is associated with maternal and fetal morbidity and mortality. We present a case of a 30-year-old primipara admitted to our department in 39th week of gestation after sudden onset of intense abdominal pain. On admission, the patient was pale, tachycardiac, but with normal blood pressure and afebrile. Symptoms of acute abdomen were clear and surgery was indicated. Diagnosis was confirmed during cesarean section. Enlarged gravid uterus compressed the ruptured artery and prevented heavier bleeding. Acute bleeding due to arterial rupture causes severe symptoms, predominantly abdominal pain. Changes in blood count become significant some time after the onset of rupture. As the gravid uterus compressed the arterial rupture, preoperative bleeding was by far less abundant than the bleeding after the baby had been delivered and the size of the uterus decreased. Any cause of acute abdomen during pregnancy (abruption of the placenta, spleen rupture, visceral artery thrombosis) requires urgent surgical treatment, as well as intraoperative and postoperative intensive treatment. Rupture of the internal iliac artery is a rare complication in pregnancy, but has to be considered as a differential diagnosis of abdominal pain.

Keywords

Iliac artery; Pregnancy; Abdominal pain; Abdomen, acute; Cesarean section

Hrčak ID:

202220

URI

https://hrcak.srce.hr/202220

Publication date:

1.3.2018.

Article data in other languages: croatian

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