Abstract

  Secondary postpartum hemorrhage is a deadly complication of postpartum period. However, often in few cases, proper diagnosis of the cause is made only at a critical stage due non-anticipation of the rare causes, which endangers the mother's life. A uterine artery pseudoaneurysm is a rare but serious complication following uterine surgery or delivery both cesarean and traumatic vaginal delivery. These pseudoaneurysms are prone to rupture even without any procedure, resulting in rapid exsanguinations. Uterine artery pseudo aneurysm, if not diagnosed promptly and treated inadequately can be catastrophic, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 37-year-oldwoman who developed recurrent secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, individual circumstances such as non-availability of the procedure and suspicion of infection and for hemodynamically unstable patients, it may not be possible to undertake arterial embolization, and hysterectomy may be still a safe option in the treatment of this life-threatening complication. However, Uterine Artery ligation may be opted when fertility preservation is desired.

Keywords: Post-Partum Haemorrhage; Pseudoaneurysm; Embolization; Uterine Artery; Hysterectomy

References

1. World Health Organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage. World Health Organization, Geneva (2012).
2. “Practice Bulletin No. 183 Summary: Postpartum Hemorrhage”. Obstetrics and Gynecology 4 (2017): 923-925.
3. Parker R., et al. “Novel approach to uterine artery pseudoaneurysm embolization for delayed post-partum hemorrhage”. Journal of Obstetrics and Gynaecology Research 12 (2016): 1870-1873.
4. Li X and Tee CSJ. “Uterine pseudoaneurysm: A rare cause of secondary post-partum hemorrhage and its management”. European Journal of Obstetrics and Gynecology and Reproductive Biology 239 (2019): 73-74.

Citation

Citation: Sujnanendra Mishra and Swadhin Kumar Mishra. “Challenging Diagnosis in Secondary Post-Partum Hemorrhage: A Case Report". Acta Scientific Women's Health 3.1 (2021): 05-07.

Copyright

Copyright: © 2021 Sujnanendra Mishra and Swadhin Kumar Mishra. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.