Ultrasound Imaging of Postpartum Hemorrhage

Abstract

ABSTRACT The etiology of postpartum hemorrhage (PPH) is diverse and management depends on identifying the cause and tailoring treatment appropriately. The major causes of PPH are uterine atony, endometritis, retained placental tissue, placental abnormalities, i.e. placenta accreta, increta and percreta, subinvolution of the placental implantation site, arteriovenous malformation (AVM), lower genital tract trauma, uterine abnormalities, bleeding disorders, coagulopathies and use of anticoagulants. Use of imaging modalities (i.e. ultrasound scanning and color and pulsed Doppler) at an early stage in the search for the etiology of PPH helps to decrease morbidity and mortality. This article reviews the differential diagnoses for bleeding in the postpartum period and assesses the role of ultrasound in the diagnosis and treatment of postpartum bleeding. By using illustrative images, the reader will be able to correlate findings on B-mode, color Doppler and 3D ultrasound in diagnosis and treatment of postpartum bleeding. It is important to be aware of the appearance of normal postpartum uterus to avoid misdiagnosis. How to cite this article Kasar P, Andonotopo W, Kupesic Plavsic S. Ultrasound Imaging of Postpartum Hemorrhage. Donald School J Ultrasound Obstet Gynecol 2015;9(2):175-187.