A case of recurrent secondary postpartum haemorrhage treated by uterine artery embolisation.

摘要

A 30-year-old primigravid patient with an uneventful antenatal period was induced at 41 weeks for reduced fetal movements. A caesarean section was performed because of pathological CTG in early labour. The operation and postoperative recovery were uneventful. She was re-admitted on the 18th postoperative day, with vaginal bleeding and lower abdominal pain. She underwent evacuation of retained products. She was re-admitted a further three times with heavy vaginal bleeding and received conservative treatment with no improvement. On the final admission on day 30, after discussion with the radiologist for conservative management of recurrent postpartum haemorrhage (PPH), a pelvic angiogram was arranged and this showed an aneurysm of the right uterine artery. A right uterine artery embolisation was successfully performed and she was discharged home the following day with post-embolisation angiography having shown complete occlusion of the right uterine artery. She was reviewed 3 weeks later and her symptoms had resolved.