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AJP Rep 2016; 06(04): e442-e444
DOI: 10.1055/s-0036-1597623
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Mili Thakur
1   Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan
2   Division of Genetic and Metabolic Disorders, Department of Pediatrics and Center for Molecular Medicine and Genetics, Wayne State University/Detroit Medical Center, Detroit, Michigan
,
Henry O. Adekola
3   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, Michigan
,
Radwan Asaad
1   Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan
,
Bernard Gonik
1   Department of Obstetrics and Gynecology, Wayne State University School of Medicine/Detroit Medical Center, Detroit, Michigan
› Author Affiliations
Further Information

Publication History

25 October 2016

12 November 2016

Publication Date:
30 December 2016 (online)

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Abstract

Secondary postpartum hemorrhage due to an intraperitoneal bleed following a vaginal delivery is extremely rare. We present a case of spontaneous rupture of the uterine artery following a normal vaginal delivery with a delayed presentation, which resulted in significant morbidity. This case discusses the presentation and management of this rare obstetrical emergency. The report also discusses the role of selective arterial embolization in management of secondary postpartum hemorrhage.

Keywords

secondary postpartum hemorrhage - spontaneous uterine artery rupture - uterine artery embolization - intraperitoneal bleeding - hemorrhagic shock

Novel Insights

Delayed intraperitoneal hemorrhage following a vaginal delivery may take the emergency room physician and obstetrician by surprise. Hypovolemic shock without external bleeding should raise the suspicion for intraperitoneal hemorrhage. Multiple surgical techniques may be required to stop bleeding. There is a role of selective arterial embolization in managing this rare cause of secondary postpartum hemorrhage.


 

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