Late postpartum hemorrhage caused by rupture of a uterine artery aneurysm in a patient with Takayasu arteritis: a case report

Abstract Background Uterine artery aneurysms are extremely rare vascular abnormalities. Their rupture during pregnancy, delivery, or the postpartum period can result in life-threatening hemorrhage, yet clinical understanding of this condition remains limited. Case presentation We report a rare case of right uterine artery aneurysm rupture that led to severe late postpartum hemorrhage. The patient was a 34-year-old Asian woman with a history of Takayasu arteritis, who presented with acute, massive vaginal bleeding 10 days after vaginal delivery. Selective arteriography confirmed that the hemorrhage was caused by the rupture of the right uterine artery aneurysm. The patient was successfully treated with selective uterine artery embolization, avoiding hysterectomy and preserving her reproductive function. Conclusions This case underscores the importance of considering uterine artery aneurysm rupture as a rare but critical cause of late postpartum hemorrhage, especially in patients with underlying vasculopathies such as Takayasu arteritis. Timely angiographic diagnosis and interventional embolization are essential for achieving hemostasis and optimizing patient outcomes.