Secondary Postpartum Hemorrhage after Cesarean Delivery: A Case Report

Delayed postpartum hemorrhage is a midwifery emergency that occurs following vaginal or cesarean delivery. It is one of the leading causes of postpartum hysterectomy and maternal death. The condition may be caused by dehiscence of uterus incision after cesarean section, which can lead to severe and fatal bleeding. We herein report a case of secondary postpartum hemorrhage after cesarean section.

 A 34-year-old G3p3 woman with severe bleeding was admitted to the maternity hospital of Yazd (Iran) in preshock state. The patient had previously had three cesarean sections and underwent elective cesarean section at 38 weeks ten days age. The patient was immediately transferred to the operating room and underwent hysterectomy. Blood transfusion and serum therapy were performed. After the surgery, the patient was kept in the intensive care unit for four days and then was transferred to gynecology ward. Finally, she was discharged on the sixth day of hospitalization after partial recovery.

Secondary postpartum hemorrhage is a deadly complication of postpartum period. However, it is often diagnosed at critical stages due to its low incidence, which may endanger the mother's life if left unattended. Therefore, it is recommended to discharge all mothers after fully explaining the complications of genital infections, so that they may seek medical attention upon appearance of alarm symptoms. Gynecologists and health professionals should follow up this group of women more carefully to prevent irreversible consequences.