Secondary Postpartum Hemorrhage due to Spontaneous Uterine Artery Rupture after Normal Vaginal Delivery Managed by Selective Arterial Embolization

Introduction: Uterine artery pseudoaneurysm is an uncommon cause of secondary postpartum hemorrhage that can be fatal. Material & Methods: We present a case of a 42-year-old woman who developed massive secondary postpartum hemorrhage 17 days after c-section and was diagnosed to have pseudoaneurysm from the left uterine artery on computed tomography scan. After blood transfusion she got hemodynamically stable and selective transcatheter arterial embolization was performed. Results: The pseudoaneurysm was successfully obliterated. Conclusions: Angiographic embolization is a safe and competent method for managing postpartum hemorrhage caused by pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the preferred method for hemodynamically unstable patients when fertility preservation is strongly desired. In a woman with unexplained vaginal bleeding after c-section , pseudoaneurysm should be considered in the differential diagnosis of secondary postpartum hemorrhage. Angiographic embolization should be examined as a treatment method before turning to surgery, in suitable selected cases.

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Secondary postpartum hemorrhage on day 58 of cesarean section due to uterine scar rupture

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20204854 ◽

2020 ◽

Vol 9 (11) ◽

pp. 4762

Author(s):

Yogita B. Gavit ◽

Deepika Sharma

Keyword(s):

Cesarean Section ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Normal Vaginal Delivery ◽

Small Subset ◽

Fatal Bleeding ◽

Uterine Scar ◽

Secondary Postpartum Hemorrhage

Secondary postpartum hemorrhage is rare and affect 0.23-3% of all pregnancies. It happens between 24 hours to 12 weeks of post-delivery. These postpartum hemorrhages occur more often during normal vaginal delivery only a small subset of postpartum hemorrhages occurs after cesarean section. Delayed postpartum hemorrhage is obstetrics emergencies that occurs following vaginal or cesarean delivery, in later condition may be caused by dehiscence of uterus incision after cesarean section which can lead to severe and fatal bleeding. We herein report a case of secondary postpartum hemorrhage after cesarean section.

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Role of Uterine Artery Embolization in Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage

Cureus ◽

10.7759/cureus.2220 ◽

2018 ◽

Cited By ~ 1

Author(s):

Saraswathy Subramaniam ◽

Chandran Nadarajan ◽

Mohd E Aziz

Keyword(s):

Postpartum Hemorrhage ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Artery Embolization ◽

Secondary Postpartum Hemorrhage

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Secondary Postpartum Hemorrhage Following Cesarean Section

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v9i1.37255 ◽

2018 ◽

Vol 9 (1) ◽

pp. 23-25

Author(s):

Surayea Bul Bul ◽

Zobaida Sultana Susan ◽

Raunak Jahan ◽

Abu Nayeem ◽

Farzana Rahman ◽

...

Keyword(s):

Cesarean Section ◽

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Causes Of Death ◽

Severe Anaemia ◽

Reproductive Age ◽

Cross Sectional ◽

Pregnancy And Childbirth ◽

Child Bearing ◽

Secondary Postpartum Hemorrhage

Background : Complications of pregnancy and childbirth have always been one of the leading causes of death and disability among women of reproductive age in developing countries .Globally, postpartum haemorrhage is the single most important cause of maternal death, accounting for about 25% of the total and claiming an estimated 1,50,000 lives annually. Among the postpartum hemorrhage, the primary postpartum hemorrhage is more prevalent, but sufferings from secondary postpartum hemorrhage have been emerging. With the rising trend of cesarean section rate, the incidence of secondary postpartum hemorrhage is also rising.Objective: The objectives of this study is to evaluate secondary postpartum hemorrhage cases following cesarean section and vaginal delivery with the aim of reducing the maternal mortality at child bearing age.Methods: This is a cross sectional observational study in the department of Obstetrics and Gynaecology, DMCH , by purposive sampling method. Total 100 cases of secondary PPH were observed during 1st January 2013 to 31 December 2013.Result: In this study, among the cases 67% were following cesarean section and 33% were following vaginal delivery, mean age of the patients were 29 year, parity ranges from 1 to 5. Regarding the outcome of secondary PPH, severe anaemia, anaemic heartfailure, renal failure and DIC were common in cesarean sections along with hazards of massive blood transfusion and jaundice. 7 patients were died in post cesarean cases and 2 died in post vaginal delivery cases. Causes of death were due to hemorrhagic shock & septicemia.Conclusion: In this is study, the rate of secondary PPH is 67% following cesarean section which is very much alarming . The outcome of secondary PPH following cesarean section is worse than vaginal delivery.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 23-25

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Transcatheter Arterial Embolization for Secondary Postpartum Hemorrhage: Outcome in 52 Patients at a Single Tertiary Referral Center

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2014.05.009 ◽

2014 ◽

Vol 25 (11) ◽

pp. 1751-1757 ◽

Cited By ~ 8

Author(s):

Hye sun Park ◽

Ji Hoon Shin ◽

Hyun-Ki Yoon ◽

Jin Hyoung Kim ◽

Dong-Il Gwon ◽

...

Keyword(s):

Transcatheter Arterial Embolization ◽

Postpartum Hemorrhage ◽

Arterial Embolization ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Referral Center ◽

Secondary Postpartum Hemorrhage

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Massive Secondary Postpartum Hemorrhage with Uterine Artery Pseudoaneurysm after Cesarean Section

Case Reports in Obstetrics and Gynecology ◽

10.1155/2013/285846 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Ahmet Ozgur Yeniel ◽

Ahmet Mete Ergenoglu ◽

Ali Akdemir ◽

Elmin Eminov ◽

Fuat Akercan ◽

...

Keyword(s):

Cesarean Section ◽

Postpartum Hemorrhage ◽

Uterine Artery ◽

Angiographic Embolization ◽

Artery Ligation ◽

Artery Pseudoaneurysm ◽

Uterine Artery Ligation ◽

Life Threatening ◽

Secondary Postpartum Hemorrhage ◽

Uterine Artery Pseudoaneurysm

Uterine artery pseudoaneurysm is a rare but serious complication of cesarean section. If inadequately treated, it can lead to life-threatening postpartum hemorrhage. Herein, we report the case of a 28-year-old woman who developed secondary postpartum hemorrhage resulting from uterine artery pseudoaneurysm and cesarean scar dehiscence after cesarean section. Angiographic embolization is a safe and effective procedure for treating postpartum hemorrhage resulting from pseudoaneurysm in hemodynamically stable patients. However, uterine artery ligation may be the surgical procedure of choice for hemodynamically unstable patients when fertility preservation is desired.

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Postpartum hemorrhage caused by uterine artery pseudoaneurysm and uterine rupture after vaginal delivery

Expert Review of Obstetrics & Gynecology ◽

10.1586/eog.12.33 ◽

2012 ◽

Vol 7 (4) ◽

pp. 313-319

Author(s):

Massimo Origoni ◽

Chiara Gelardi ◽

Federica Pasi ◽

Stefano Salvatore ◽

Massimo Candiani

Keyword(s):

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Uterine Rupture ◽

Uterine Artery ◽

Artery Pseudoaneurysm ◽

Uterine Artery Pseudoaneurysm

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Immersion in Water During Active Labor Decreases Postpartum Hematocrit Fall Following Vaginal Delivery

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2018.824 ◽

2018 ◽

pp. 1

Author(s):

Gul Nihal Buyuk ◽

Serkan Kahyaoglu ◽

Ezgi Turgut ◽

Omer Hamid Yumuşak ◽

Caner Kose ◽

...

Keyword(s):

Vaginal Delivery ◽

Postpartum Hemorrhage ◽

Study Groups ◽

Normal Vaginal Delivery ◽

Control Group ◽

The Mean ◽

Group 2 ◽

Water Birth ◽

Control Group Group ◽

Group 1

OBJECTIVE: The objective of the study was to investigate the effect of immersion in water strategy during labor on postpartum bleeding by calculating the postpartum reduction rates of the hematocrit values of the patients.STUDY DESIGN: The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (group 1) and the control group (group 2) of 84 women undergoing normal vaginal delivery. Patients who have received additional medical and surgical interventions for alleviation of postpartum hemorrhage, patients who have undergone an episiotomy and/or perineal trauma were not included in the study. All data were taken from patients who have delivered with spontaneous vaginal delivery. Postpartum hematocrit fall rates of the groups have been compared and the effect of immersion in water on postpartum hemorrhage has been evaluated.RESULTS: The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (Group 1) and the control group (Group 2) of 84 women undergoing vaginal delivery at the hospital. The women in the two groups were matched with respect to age, parity, birth weight and gestational age. The mean age of the women was 29.8±4.8 and 30.5±4.9 respectively. The mean hematocrit difference in the first group was 2.08 ± 1.88 and in the second group was 3.81 ± 1.55. The mean percentage of hematocrit reduction in the first group was 5.71% and in the second group 10.23%.CONCLUSION: Our data showed that mean hematocrit level decreases among women following vaginal delivery more than women who give birth vaginally within immersion in water during labor. The percentage of hematocrit reduction in the water birth group was lower than in the control group. Water birth seems to facilitate uterine contractions more efficiently following vaginal delivery.

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Secondary postpartum hemorrhage due to uterine artery pseudoaneurysm

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2021.12.00550 ◽

2021 ◽

Vol 12 (2) ◽

Author(s):

Alexis Svokos MD ◽

Kendall Cunningham MD ◽

Maranda Sullivan DO ◽

Saif Ahmed MD

Keyword(s):

Pulmonary Embolism ◽

Cesarean Section ◽

Postpartum Hemorrhage ◽

Uterine Artery ◽

Artery Pseudoaneurysm ◽

Secondary Postpartum Hemorrhage ◽

The Right ◽

Uterine Artery Pseudoaneurysm

We present the case of a 26-year-old female who experienced secondary postpartum hemorrhage nine days after an uncomplicated elective repeat low transverse cesarean section. She was found to have a uterine pseudoaneurysm and underwent gel foam embolization of the right uterine artery. Subsequently, patient was diagnosed with pulmonary embolism on post-embolization day 3, and was initiated on anti-coagulation regimen.

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