Postpartum Uterine Wound Dehiscence Leading to Secondary PPH
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Introduction
Secondary postpartum haemorrhage (PPH) after caesarean occurs in about 1?:?365 cases . The most common etiological factors are retained products of conception and subinvolution of the placental site. A rare cause is partial or complete dehiscence of the lower uterine segment incision [1]. The patient may present with excessive vaginal bleeding and pelvic pain as early as 11 days to as late as 12 weeks after surgery [2]. She may also present with dysmenorrhoea and intermenstrual bleeding a few years after the caesarean section (CS) [2]. We present here a patient with secondary PPH following uterine dehiscence after caesarean delivery who was managed conservatively initially but eventually needed hysterectomy.

Case Report
A 27-year-old para 2 with two previous caesarean sections was referred to us with postpartum heavy bleeding with passage of clots for one day. There was a history of similar episode 2 weeks back when she was managed conservatively with 3 units of packed cells and intravenous antibiotics. There was no history of fever, unhealthy vaginal discharge, or wound infection. She had an elective caesarean section 10 weeks back. The caesarean section was done for thin scar (1?mm) detected on routine ultrasound....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3376497/
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