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Fertility preserving management for postpartum haemorrhage secondary to subinvolution of the placental implantation site
  1. Ruoxing Du1,
  2. Rebecca Davies1 and
  3. Prasanna Raj Supramaniam1,2
  1. 1Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford, UK
  2. 2Nuffield Depeartment of Women's & Reproductive Health, University of Oxford, Oxford, Oxfordshire, UK
  1. Correspondence to Prasanna Raj Supramaniam; Prasanna.Supramaniam{at}


A 40-year-old woman presents with recurrent secondary postpartum haemorrhage (PPH) following her third normal vaginal delivery. Histology from subsequent evacuation of the uterus confirmed that she had subinvolution of the placental implantation site. Hysterectomy is the most common method of managing this condition and recurrent PPH, most often due to significant vaginal bleeding. We present a case of subinvolution of the placental implantation site with recurrent PPH managed with medical treatment alone, to offer a fertility-sparing treatment option.

  • drugs: obstetrics and gynaecology
  • pregnancy
  • reproductive medicine
  • ultrasonography

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  • Contributors RD wrote the manuscript and did the literature search for the paper. RDavies was involved in the patient care, initial correspondence with the patient and editing the manuscript. PS edited the manuscript and oversaw the development of the manuscript. All authors have read and approved the final version of the manuscript submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.