Objectives

The purpose of the present study was to evaluate the computed tomography findings of postpartum hemorrhage and discuss relevant anatomical findings and possible mechanism(s).

Background

Postpartum hemorrhage (PPH) is an obstetric emergency that can follow vaginal or cesarean delivery. Even though computed tomography (CT) is not presently an appropriate first-line diagnostic procedure for the evaluation of PPH, it can provide information leading to its detection, localization, and characterization in certain challenging cases. Further, contrast CT can accurately identify the anatomic location of significant arterial hemorrhage based on the extravasation of intravenous contrast material; this will help guide treatment planning and execution.

The findings of this study provide important knowledge regarding the various radiologic appearances of PPH and their correlation with clinical information.

Imaging findings OR Procedure findings

Normal anatomy of the reproductive organs in women with illustrations

Radiologists require an extensive anatomical knowledge of the reproductive organs, supplying vessels, and supporting ligaments in women for the accurate diagnosis of PPH.

Imaging findings of emergency PPH

●Uterine atony: the lack of effective uterine contractions after delivery

●Retained placenta: the lack of placental expulsion within 30 minutes after delivery of the infant

● Puerperal genital hematoma: resulting from episiotomy trauma or birth canal trauma

● Uterine rupture: the most common cause is tearing along a previous cesarean hysterectomy scar

Conclusion

The knowledge of the various radiological appearances of PPH and their correlation with clinical information can ensure accurate diagnosis and appropriate treatment planning in the patients with PPH.