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Late postpartum hemorrhage after hemostatic square suturing technique: a case report
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
The Journal of Reproductive Medicine
|August 21, 2009
Summary
Late postpartum hemorrhage can occur after using the hemostatic square suture technique. This case report details a patient experiencing significant bleeding weeks after the procedure.
Area of Science:
- Obstetrics and Gynecology
- Surgical Techniques
- Maternal-Fetal Medicine
Background:
- Postpartum hemorrhage (PPH) is a leading cause of maternal mortality.
- Hemostatic square suturing is an effective surgical intervention for PPH.
- Potential complications associated with hemostatic square sutures require further investigation.
Observation:
- A 36-year-old woman with placenta previa and percreta underwent emergency cesarean section.
- Hemostatic square suture successfully controlled intraoperative massive bleeding.
- Developed late postpartum hemorrhage with a complex intrauterine mass 37 days post-operation.
Findings:
- The patient presented with recurrent massive vaginal bleeding.
- Ultrasonography revealed a significant intrauterine mass.
- Treatment with uterotonics and blood transfusion normalized beta-human chorionic gonadotropin levels and resolved the mass.
Implications:
- This case highlights a potential delayed complication of hemostatic square suturing.
- Clinicians should consider late postpartum hemorrhage as a possible sequela.
- Further research is needed to understand the pathophysiology and incidence of this complication.