Embrittlement of uterus after uterine artery embolization: a case of uterine perforation

Uterine artery embolization (UAE) is a common treatment for postpartum hemorrhage, however, the influences on uterus have yet to be uncertain. Here, we present a case of uterine embrittlement and perforation after UAE. A 30-year-old primipara received UAE for postpartum hemorrhage. Enhanced magnetic resonance imaging (MRI) after UAE showed lack of enhancement on uterine fundus. She complained hypomenorrhea after UAE, thus hysteroscopy was performed for intrauterine synechia. During the surgery, uterine perforation, which identical with the ischemic part on MRI, was found. It was repaired laparoscopically together with vulnerable surrounded area. With the case, because UAE tend to choose for woman who desire for the next pregnancy, we recommend that UAE should be limited and performed only for cases that could not accomplished hemostasis even with other methods. When UAE was chosen reluctantly, uterine myometrium ischemia should be monitored by contrast enhanced MRI.