Delayed post-partum hemorrhage
• Bleeding occurring 1 to 2 weeks into the puerperium.
• May result from retained products of conception or abnormal placental site involution.
• The retained piece of the placenta may become calcified forming a placental polyp.
• Treatment with ergometrine, misoprostol and Prostaglandin is conservative and preserves the uterus.
• Surgical treatment with gentle dilatation and curettage is reserved for severe bleeding or if medical treatment fails. Beware of overzealous curettage as this may lead uterine synechiae (Asherman’s syndrome).