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An unusual cause of delayed postpartum haemorrhage following caesarean section
  1. S Samad,
  2. P Jonetzko,
  3. A P Hawkins,
  4. J Booth,
  5. G Thorpe-Beeston,
  6. R Marwood
  1. Chelsea and Westminster Hospital, London, UK
  1. Dr S Samad, Chelsea and Westminster Hospital, London, UK; sazia.samad{at}


Although less common in the UK, postpartum haemorrhage (PPH)—defined as blood loss of 500 ml or more within the first 24 h of delivery— remains a significant cause of maternal death worldwide. Haemorrhage between 24 h and 6 weeks post partum is termed “delayed PPH”. Common causes include retention of gestational products or endometritis. Bleeding can be sudden and profound, resulting in rapid cardiovascular collapse. A case of massive PPH 7 weeks after a caesarean section caused by a pseudoaneurysm of the uterine artery is reported. This case highlights diagnostic and therapeutic issues concerning this rare but potentially life-threatening condition and presents clinical features distinguishing it from other causes of PPH. Delay in diagnosis can result in repeated and catastrophic bleeding.

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  • Funding: None.

  • Competing interests: None.

  • Patient consent: Obtained.