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Berns, Annike Ida
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Health Professions Medicine & Pharmacology Nursing Public Health

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A Rare Cause of Secondary Postpartum Hemorrhage: Uterine Scar Dehiscence with Cervico-Isthmic Laceration After Repeat Cesarean Section Berns, Annike Ida; Ayuandari, Sarrah; Maliki, Fauzan Achmad; Prawitasari, Shinta; Ariffianto, Adi
JURNAL KESEHATAN REPRODUKSI Vol 13, No 1 (2026)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.118397

Abstract

To describe a rare and atypical case of secondary postpartum hemorrhage (PPH) induced by uterine scar dehiscence in conjunction with an unexplained uterine laceration in the cervico-isthmic region. We report the case of a 29-year-old woman, gravida 2 para 2, who had significant vaginal bleeding and signs of hemorrhagic shock 10 days post-repeated cesarean section. The bleeding was not controlled despite initial resuscitation and medical care. Transabdominal ultrasonography revealed signs of pathology at the previous cesarean scar site. Due to persistent hemodynamic instability, an emergency laparotomy was conducted, exposing active hemorrhage from uterine scar dehiscence, as well as a laceration extending caudally into the cervico-isthmic area, without a clearly identifiable cause. Definitive management required total hysterectomy to achieve hemostasis. This case highlights the importance of consideration of structural causes when medical treatment fails, as early surgical intervention can be life-saving.
Co-Authors Ariffianto, Adi Ayuandari, Sarrah Fauzan Achmad Maliki Shinta Prawitasari