An Atypical Presentation of Late Postpartum Hemorrhage: A Case Report

Abstract

In this case report, late postpartum cyclic uterine bleeding is demonstrated and is unique in literature with its clinical course. A 21 year old patient admitted with massive vaginal bleeding. It was learnt that the patient had cesarean delivery 40 days ago. In pelvic examination there was active vaginal bleeding. The uterine involution was completed. In ultrasonography uterus was normal and there was not any placental rest in uterine cavity. In laboratory; hemoglobin was 7.2gr/dl, other values were normal. Oxytocin infusion, methylergobasine maleate and antibiotic were administered. Blood transfusion was done. Patient was discharged after follow-up. Patient admitted twice again with same symptoms with 1 month intervals. Laparotomy was planned. During laparotomy, uterine incision site was opened. Hemorrhage was present within endometrial cavity. There were vessels bleeding on the right side of incision and 2x2 cm sized rest of amniotic membrane. The rested tissue was extirpated and vessels were sutured. The patient was discharged after 3 days of follow-up.