Complicação Hemorrágica Pós-Cesárea Por Ruptura De Artéria Uterina Com Necessidade De Reabordagem Cirúrgica: Relato De Caso

Postpartum hemorrhage (PPH) is defined as blood loss of 500 mL or more after vaginal delivery or 1000 mL after cesarean section. It is one of the main causes of maternal morbidity and mortality in the postpartum period. If not treated appropriately and timely, it can progress to hypovolemic shock, multiple organ failure, and maternal death. Its causes are traditionally classified according to the “4 Ts” model: Tone, Trauma, Tissues, and Thrombin. Uterine atony, characterized by the absence of effective uterine contractions after delivery, is the main etiology, accounting for approximately 70% of cases. Other relevant causes include lacerations of the birth canal, retained placental remains, uterine rupture, and coagulation disorders. This report describes the case of a 19-year-old postpartum admitted with mild preeclampsia and undergoing elective cesarean section after failed labor induction. She developed significant bleeding in the first postoperative hours. The patient underwent resurfacing, which revealed bleeding due to retraction of the left uterine artery and the formation of a retroperitoneal hematoma, which were resolved with compressive sutures. This case highlights the importance of intensive surveillance in the immediate postoperative period and prompt surgical intervention in the face of hemorrhagic complications. Keywords: Hypotension. Obstetric surveillance. Revision surgery. Maternal hemodynamics. Perinatal emergency.