Imaging of Antepartum and Postpartum Hemorrhage

Kira Melamud1, Shaun A Wahab1, Paul N Smereka1

  • 1From the Department of Radiology, New York University Grossman School of Medicine, New York, NY (K.M., P.N.S., N.M.H.); Department of Radiology, University of Cincinnati College of Medicine, Mason, Ohio (S.A.W.); Department of Radiology, University of Washington Medical Center, Seattle, Wash (M.K.D.); Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada (P.G.); Department of Radiology, Mount Sinai Hospital, New York, NY (A.K.); University of Pittsburgh Medical Centre, Pittsburgh, Pa (E.M.); Departments of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (L.M.S.); and Department of Radiology, NYU Langone Health, 660 1st Ave, 3rd Floor, New York, NY 10016 (N.M.H.).

Severe obstetric hemorrhage is a leading cause of maternal mortality and morbidity worldwide. Major hemorrhage in the antepartum period presents potential risks for both the mother and the fetus. Similarly, postpartum hemorrhage (PPH) accounts for up to a quarter of maternal deaths worldwide. Potential causes of severe antepartum hemorrhage that radiologists should be familiar with include placental abruption, placenta previa, placenta accreta spectrum disorders, and vasa previa. Common causes of PPH that the authors discuss include uterine atony, puerperal genital hematomas, uterine rupture and dehiscence, retained products of conception, and vascular anomalies. Bleeding complications unique to or most frequently encountered after cesarean delivery are also enumerated, including entities such as bladder flap hematomas, rectus sheath and subfascial hemorrhage, and infectious complications of endometritis and uterine dehiscence. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by Javitt and Madrazo in this issue.

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