MRA Mapping and Selective Embolization of a Large Uterine Cavity Pseudoaneurysm at 20 Weeks of Gestation

Antepartum uterine cavity pseudoaneurysm rupture can cause massive hemorrhage with high maternal and fetal mortality risk. Invasive placentation can predispose to vascular malformations. We present a novel use of macrocyclic intravenous contrast-enhanced magnetic resonance angiography for preprocedure planning followed by selective low radiation embolization of a uterine cavity pseudoaneurysm in the setting of invasive placentation at 20 weeks of gestation. To our knowledge, this is the first reported case of uterine cavity pseudoaneurysm successfully mapped with MRA and treated with embolization at 20 weeks of gestation.