Rupture of internal pudendal artery aneurysm following spontaneous vaginal delivery: An uncommon cause of post-partum bleeding

Pregnancy-related rupture of an arterial aneurysm is an unusual occurrence associated with increased risk of morbidity and mortality. Various pregnancy-related physiologic changes appear to make pregnancy a high-risk situation for rupture of either preexisting arterial aneurysms or those that develop throughout the course of pregnancy. Splenic artery aneurysms are the most common (60%), followed by hepatic (20%), superior mesenteric (5.9%), celiac (4%), ovarian, uterine, and renal (52%) artery. Even rarer are aneurysms involving the internal iliac artery and its branches, to which there is only one published case report. In this report, we present a case of a 34-year-old pregnant gravida(1) para(0) who, following a normal vaginal delivery, had a severe rupture of the right internal pudendal artery and subsequently developed a massive hematoma which ultimately required embolization treatment.