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

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.

• References

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