Title: An Interesting Case of Secondary Post Partum Haemorrhage

Authors: Dr Sowmya Varudu, Dr Renuka Devi, Dr R. Jayanthi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.61

Abstract

  

Introduction

Secondary postpartum haemorrhage (PPH) is defined as bleeding from or into the genital tract 24 hours after the birth of the baby within 6 weeks postpartum. It affects only 1-2 % of postnatal women. This low incidence of secondary PPH and its linkage to maternal morbidity rather than mortality was the reason for the little attention among obstetricians, but it is recently gaining importance and interest with the increasing  morbidity and mortality.(1) Globally PPH remains the leading cause of maternal deaths. However in many low income countries (which accounts for highest burden) like India, there is still scarcity of information on magnitude of and risk factors for PPH. The jeopardy of PPH is rising with the secondary form of PPH, when women are already discharged home.PPH is widely underestimated obstetric problem with variable occurrence and severity when diagnosed. The most common aetiological factors are retained products of conception and sub involution of placental site/ endometritis(1)(6). A rare cause is partial or complete dehiscence of lower uterine segment incision(8), placental site trophoblastic tumour or choriocarcinoma.

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