Conservative surgical management of placental implantation site hemorrhage.

BACKGROUND

Our purpose is to show that a simple, conservative, fertility-preserving surgical technique can be used to control postpartum hemorrhage from a hypotonic placental implantation site.

CASE: Postpartum hemorrhage from a hypotonic placental implantation site at cesarean delivery was treated with surgical excision of the hypotonic segment, resulting in immediate cessation of the bleeding when other measures had failed. The patient's postoperative course was uneventful. The uterus and adjacent vascular structures were evaluated with magnetic resonance imaging studies at 4 weeks postpartum and were free of abnormality.

CONCLUSION

Simple excision of a hypotonic bleeding site may be desirable and practical when fertility preservation is desired.