Massive Postpartum Hemorrhage Following an Inner Myometrial Laceration: A Case Report

Background and Aim : Postpartum hemorrhage has different etiologies. One of the rare causes is innermyometrial laceration that makes the diagnosis more difficult. This report aimed to introduce a case ofmassive postpartum hemorrhage following an inner myometrial laceration.Methods : A 24-year-old primigravid woman referred to an academic Hospital due to hypertension of140/90 and diagnosis of preeclampsia. Her pregnancy was terminated at 39th gestational week. Shereceived two doses of 25 μg misoprostol sublingually. Subsequently, an induction was performed andnormal vaginal delivery occurred. A 2800 gr infant was born. After the delivery, the patient suffered frommassive postpartum hemorrhage which continued in spite of all medical treatments. With regard of unstablevital signs, laparotomy was done. By transverse uterine incision, a longitudinal inner myometrial lacerationwas found in the lower uterine segment, which was repaired, thus, hemorrhage was controlled.Results : An inner myometrial laceration is one of the differential diagnoses of postpartum hemorrhagewhich should be taken into consideration. Laparotomy and hysterotomy for repairing the inner myometriallaceration would control postpartum hemorrhage and could avoid hysterectomy.Conclusion : An inner myometrial laceration is one of the differential diagnoses of postpartum hemorrhagewhich should be taken into consideration. Laparotomy and hysterotomy for repairing the inner myometriallaceration would control postpartum hemorrhage and could avoid hysterectomy.

کلیدواژه ها:

Postpartum hemorrhage ، Inner myometrial laceration ، Labor ، Increased intrauterine pressure