This article reports a case of postpartum hemorrhage with an unusual shunt between the uterine artery and profunda femoris artery detected during UAE was retrospectively analyzed, including imaging findings, management strategy, and outcome.

Superselective angiography revealed an abnormal communication between the ascending branch of the left uterine artery and the profunda femoris artery, with reflux opacification of the superficial femoral artery. The descending branch of the left uterine artery was embolized with gelatin sponge particles, while the small shunt in the ascending branch was not treated. Hemorrhage was successfully controlled without ectopic embolization or lower limb ischemic complications.

Although rare, abnormal communication between the uterine artery and profunda femoris artery is clinically significant. Careful preoperative and intraoperative imaging evaluation, standardized superselective techniques, and appropriate embolization strategies are essential to reduce the risk of ectopic embolization.