Recurrent late postcesarean section hemorrhage due to pseudoaneurism formation

Postcesarean section pseudoaneurismal changes in the local uterine arterial wall are rare. Usually, the patient presents in hypovolemic shock with recurrent massive vaginal bleeding. Herein, we report on two patients who had recurrent massive hemorrhage on the days 17, 21, and 50 after an uncomplicated elective cesarean section. These patients had severe hemorrhage and hypovolemic shock. After general evaluation, they were treated with multiple broad-spectrum antibiotics, uterotonic medications, dilatation and curettage, and hysterectomy (case 1) and ligation of the feeding vessel (case 2).Pathology report of the first patient revealed pseudoaneurismal changes in the uterine arterial vessels at the site of cesarean incision.