A rare cause of secondary postpartum haemorrhage

Abstract

Secondary postpartum haemorrhage (PPH) after caesarean section due to uterine artery pseudoaneurysm is an unusual complication. We report a case of 26 years-old female (P2L2) who had lower segment caesarean section (LSCS) was presented after 36th day with excessive bleeding per vagina for 1 day. She was diagnosed to have pseudoaneurysm by CT angiography. Selective transcatheter arterial embolization of pseudoaneurysm was planned and digital substraction angiography was done. Left iliac arteriogram revealed a pseudoaneurysm from the terminal part of the left uterine artery. Post-operative period was uneventful and the bleeding stopped. In conclusion, pseudoaneurysm of uterine artery should be considered as a differential diagnosis, when the patient presents with secondary PPH after caesarean section. Embolisation is the treatment of choice and its prevents a hysterectomy.