BACKGROUND:

Late puerperal hemorrhage is a major morbidity and mortality that requires urgent action. Its cause is very varied and requires careful assessment to stop it without complications.

CLINICAL CASE:

A 42-year-old woman came to the emergency department five weeks after cesarean section for heavy puerperal bleeding. After curettage and thorough examination in the operating room, ultrasound identified an anechogenic parauterine area suggestive of aneurysmal dilatation in communication with the uterine cavity. The diagnosis was established based on angiography and confirmed after embolization by interventional radiology, without mishap, and resolution of the picture. The patient was discharged in two days, with subsequent revisions reported as normal.

CONCLUSIONS:

Vascular pathology should be part of the differential diagnosis of late puerperal hemorrhage and, if properly diagnosed, may facilitate the therapeutic procedure by interventional radiology and thus avoid other more invasive treatments.