Severe secondary postpartum haemorrhage after caesarean section

Between January 1982 and April 1985 13 patients with severe secondary postpartum haemorrhage after caesarean section were seen at King Edward VIII Hospital, Durban. The bleeding occurred in the second, third and fourth weeks after delivery, but there were no maternal deaths. Eight of these patients were treated by total abdominal hysterectomy and 1 by revision of the uterine wound and ligation of the bleeding uterine vessels. The last 4 patients, seen in 1985, were treated by selective transcatheter embolisation with Gelfoam pledgets. This method was successful in 3 patients and failed in 1. It is suggested that the latter method has a place in the treatment of these patients.