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Case Reports
. 2021 Feb 8;14(2):e238945.
doi: 10.1136/bcr-2020-238945.

Subinvolution of the placental site as the cause of hysterectomy in young woman

Olga Triantafyllidou  1 , Stavroula Kastora  2   3 , Irini Messini  4 , Dimitrios Kalampokis  5
Affiliations
Case Reports

Subinvolution of the placental site as the cause of hysterectomy in young woman

Olga Triantafyllidou et al. BMJ Case Rep. .

Abstract

Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.

Keywords: pregnancy; reproductive medicine.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Subinvolution of uteroplacental arteries. Dilated, clustered, myometrial arteries with partial obliteration by thrombi (haematoxylin-eosin staining, magnification: ×400.
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