An unusual cause of delayed postpartum haemorrhage following caesarean section.
Although less common in the UK, postpartum haemorrhage (PPH)--defined as blood loss of 500 ml or more within the first 24 h of delivery--remains a significant cause of maternal death worldwide. Haemorrhage between 24 h and 6 weeks post partum is termed "delayed PPH". Common causes include retention of gestational products or endometritis. Bleeding can be sudden and profound, resulting in rapid cardiovascular collapse. A case of massive PPH 7 weeks after a caesarean section caused by a pseudoaneurysm of the uterine artery is reported. This case highlights diagnostic and therapeutic issues concerning this rare but potentially life-threatening condition and presents clinical features distinguishing it from other causes of PPH. Delay in diagnosis can result in repeated and catastrophic bleeding.
Samad
S
S
Chelsea and Westminster Hospital, London, UK. sazia.samad@doctors.org.uk
Jonetzko
P
P
Hawkins
A P
AP
Booth
J
J
Thorpe-Beeston
G
G
Marwood
R
R
D017541:Aneurysm, False / Q000150:complications* / Q000000981:diagnostic imaging; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D011859:Radiography; D014599:Uterus / Q000098:blood supply*