Managing Ovarian Pseudoaneurysm in Pregnancy: Innovative Use of Transvaginal Sonography-guided Thrombin Injection

Abstract

Spontaneous pseudoaneurysms of the ovary in pregnancy are exceedingly rare. They are difficult to diagnose, and there is seldom a suspicion of such pathology during routine obstetric scans. Transvaginal sonography (TVS) is important in diagnosing rare ovarian pathologies like pseudoaneurysm and their characterization. Further, TVS-guided embolotherapy with thrombin in such pathology is safer and easily accessible. Thrombin as an embolic agent is more physiological, with fewer chances of adverse effects on fetoplacental circulation in case of retrograde reflux or inadvertent embolization. We hereby report a case of innovative use of TVS-guided thrombin injection in ovarian pseudoaneurysm and a successful cure with a 6-month follow-up. The ovarian pseudoaneurysm sac got completely thrombosed immediately, with significant pain relief in a follow-up of 6 months. TVS-guided thrombin injection can be safely used as a treatment modality in ovarian pseudoaneurysm in pregnancy with immediate symptomatic improvement.