Rare But Life-Threating Delayed Postpartum Hemorrhage After C-Section

Delayed Postpartum Hemorrhage
Delayed Postpartum Hemorrhage

(HealthDay News) — Uterine artery pseudoaneurysm has been described after cesarean delivery and can result in life-threatening hemorrhage if untreated, according to a case report published in the September issue of Obstetrics & Gynecology.

Kushal Chummun, MD, from St. Vincent University Hospital in Dublin, and colleagues present a case of delayed diagnosis of uterine artery pseudoaneurysm following cesarean delivery.

The researchers describe the case of a 34-year-old woman who underwent urgent cesarean delivery for labor dystocia, which was complicated with hemorrhage from the uterine incision angles, necessitating extra hemostatic suture. The patient presented with secondary postpartum hemorrhage on day 14. Four months post-cesarean delivery, she presented again with life-threatening post-coital vaginal bleeding. On magnetic resonance imaging and angiography, a uterine artery pseudoaneurysm was revealed, which was treated with uterine artery embolization.

"Uterine artery pseudoaneurysm should be considered as a differential diagnosis in patients presenting with postpartum hemorrhage, especially if bleeding is significant and recurrent, particularly after an operative delivery," the authors write. "The diagnosis of a pseudoaneurysm can be made by color Doppler ultrasonography, computed tomography, magnetic resonance imaging, and angiography."

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