Postcaesarean Pseudoaneurysm of Uterine Artery Causing Secondary Postpartum Hemorrhage Managed With Embolization: A Case Report.

Abstract

Background and aims: Secondary postpartum hemorrhage (SPPH) is defined as the hemorrhage occurring beyond 24 h and within the puerperium (6 weeks). The incidence of SPPH is 0.21%. Pseudoaneurysm of the uterine artery is a rare cause of SPPH following the caesarean or vaginal delivery and is reported to be developed as a complication of vascular trauma during caesarian section or after uterine curettage and pelvic surgery. Prompt diagnosis and early management should be done to avoid the complications.

Methods: An informed written consent was taken from a patient for writing the case. A brief literature review was done for writing the case.

Results: In our case, the patient had recurrent vaginal bleeding following LSCS where she was managed conservatively along with multiple blood transfusions. The final diagnosis was made on the 48th day postpartum. This highlights the necessity of considering further investigation to rule out the rare causes of SPPH like pseudoaneurysm and also emphasizes the role of TAE in the management of such cases.

Conclusion: Early diagnosis and management of SPPH is crucial to reduce complications in patients. Pseudoaneurysm should be ruled out, though rare in patients presenting with recurrent vaginal bleeding in the postpartum period. Pseudoaneurysm can be effectively managed with the TAE considering its advantages.