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Delayed postpartum hemorrhage in adenomyosis: a case report
1Department of Obstetrics and Gynecology, Veterans General Hospital-Taipei, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|September 24, 1998
Summary
Adenomyosis, a uterine condition, can cause infertility and severe postpartum hemorrhage. This case highlights the risks of adenomyosis during pregnancy, necessitating hysterectomy after a difficult recovery.
Area of Science:
- Reproductive Medicine
- Gynecology
- Obstetrics
Background:
- Adenomyosis is a uterine condition associated with infertility in women of reproductive age.
- Pregnancy in women with adenomyosis presents unique challenges and potential complications.
Observation:
- A 26-year-old woman with a history of adenomyosis experienced a spontaneous pregnancy.
- She developed delayed, severe postpartum hemorrhage (PPH) 20 days after Cesarean delivery.
- The PPH was tenacious and unresponsive to conservative management, including hormonal therapy and uterine packing.
Findings:
- The patient required emergency laparotomy and subtotal hysterectomy due to intractable hemorrhage.
- Pathological examination confirmed extensive adenomyosis as the primary uterine abnormality.
- No other significant pathological findings were noted in the uterus.
Implications:
- This case underscores the significant risks of adenomyosis in pregnancy, particularly concerning postpartum hemorrhage.
- Clinicians should consider adenomyosis as a potential risk factor for severe PPH in the postpartum period.
- The potential dangers of adenomyosis in pregnancy warrant careful consideration for women seeking infertility treatment.