Scar Dehiscence: An Alarming Cause of Secondary Postpartum Hemorrhage Case Report

Introduction: Cesarean scar dehiscence is a very rare, but grave cause of postpartum hemorrhage (PPH), in which the scar tissue of the previous Cesarean Section (CS) is disrupted and separated. We present a case of a 24 years female, who presented with two episodes of secondary PPH, post cesarean section and on evaluation was found to have uterine scar dehiscence. Case Summary: The patient reported to the labour room emergency with complaints of excessive bleeding per vaginum. She had an uneventful antenatal period, and underwent emergency lower segment cesarean section (LSCS) few days ago. Her postoperative period was uneventful and she was discharged on postoperative day (POD) 3 of LSCS. Examination and investigations did not reveal any abnormal nding and the patient was discharged after conservative management. She again reported with the same complaints few days later. In view of second bout of haemorrhage, MRI (magnetic resonance imaging) was done which revealed a focal defect in anterior wall of uterus, at incision site, likely scar dehiscence, which was surgically managed by laparotomy followed by debridement of scar and re-suturing of uterus. The patient was discharged with stable vitals, with no further complaints. Cesarean scar dehiscence, although rare, but is a l Conclusion: ethal cause of secondary PPH, and it is often overlooked. It has many immediate and long term fatal complications. More case series and case reports are needed to frame uniform guidelines in detecting and early management of such cases.