Yusva Gunawan dan Risanto Siswosudarmo
Bagian/SMF Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada//RS. Sardjito, Yogyakarta
Abstract
Yusva Gunawan, Risanto Siswosudarmo: Late Postpartum Hemorrhage due to Dehiscence in the Lower Uterine Segment: A Case Report
Background: Late postpartum hemorrhage is bleeding 24 hours after delivery. It can be caused by retained placental fragment, infection, or subinvolution. Postpartum hemorrhage after cesarean section might be due to dehiscence of the lower uterine segment closure.
Objective: To discuss the management of post partum hemorrhage after cesarean section due to dehiscence of lower uterine segment.
Case: Two cases of post partum hemorrhage were admitted to hospital because of hypovolemic shock. Vaginal ultrasound examination showed a dehiscence on the lower uterine segment. Laparotomy was performed for both cases. Hysterectomy was done on the first case because of severe infection on the incisional site, while hysteroraphy was done on the second case because it was a clean wound, and preservation of fertility was still needed.
Keywords: late postpartum bleeding – cesarean section – lower uterine segment dehiscence – hysterectomy– hysteroraphy.