Fertility preserving management for postpartum haemorrhage secondary to subinvolution of the placental implantation site

Ruoxing Du; Rebecca Davies; Prasanna Raj Supramaniam

doi:10.1136/bcr-2021-245009

Fertility preserving management for postpartum haemorrhage secondary to subinvolution of the placental implantation site

BMJ Case Rep. 2021 Sep 30;14(9):e245009. doi: 10.1136/bcr-2021-245009.

Authors

Ruoxing Du¹, Rebecca Davies¹, Prasanna Raj Supramaniam^{2

3}

Affiliations

¹ Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford, UK.
² Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford, UK [email protected].
³ Nuffield Depeartment of Women's & Reproductive Health, University of Oxford, Oxford, Oxfordshire, UK.

Abstract

A 40-year-old woman presents with recurrent secondary postpartum haemorrhage (PPH) following her third normal vaginal delivery. Histology from subsequent evacuation of the uterus confirmed that she had subinvolution of the placental implantation site. Hysterectomy is the most common method of managing this condition and recurrent PPH, most often due to significant vaginal bleeding. We present a case of subinvolution of the placental implantation site with recurrent PPH managed with medical treatment alone, to offer a fertility-sparing treatment option.

Keywords: drugs: obstetrics and gynaecology; pregnancy; reproductive medicine; ultrasonography.

Publication types

Case Reports

MeSH terms

Adult
Delivery, Obstetric
Female
Humans
Hysterectomy
Placenta
Postpartum Hemorrhage* / etiology
Postpartum Hemorrhage* / surgery
Pregnancy
Uterus