Publication:

Successful management of secondary postpartum haemorrhage due to post caesarean wound dehiscence with uterine artery embolisation

Caesarean scar dehiscence usually presents as secondary postpartum haemorrhage (PPH) with persistent spotting, fever or abdominal distension. The known management are either with laparotomy followed by resuturing of the scar or hysterectomy. However, most of the patient ultimately undergo hysterectomy due to the persistence of vaginal bleeding. We presented a case of PPH secondary due to scar dehiscence post lower segment caesarean section (LSCS), which was successfully managed with bilateral uterine artery embolization without hysterectomy. Our patient presented with vaginal bleeding on 16th post LSCS day and USG showed presence of a hyperechoic area measuring 5×6 cm more towards the right angle suggestive of the scar dehiscence with hematoma. She underwent bilateral uterine artery embolization and had decreased in the vaginal bleeding with gradual regression in the size of the hematoma over a period of time. Radiological intervention with bilateral uterine artery embolization (UAE) can be used as one of the modalities of management for the hemodynamically stable patient.