Iliac artery aneurysm is an extremely rare vascular disorder occurring in about 0.03% of the population. Sudden hemodynamic changes along with the radiological findings of free abdominal fluid warrants for further surgical intervention, as the heavily gravid uterus during pregnancy that compresses on the aneurysm undergoes a sudden reduction of size postpartum and the associated changes in pressure gradient on the artery post delivery may cause sudden rupture of the iliac artery aneurysm. Rupture of the internal iliac artery is a rare complication in pregnancy and in postpartum but should be considered as a differential diagnosis of abdominal pain post partum.
We are present a 29 year old para 3+0 who delivered via SVD with normal antenatal, intrapartum and immediate postpartum vitals. On day 1 Post-Partum the patient went into cardiovascular arrest secondary to hypovolemic shock, the postmortem revealed ruptured right internal iliac artery aneurysm.
Wong Li Ping