Imaging of Antepartum and Postpartum Hemorrhage

Radiographics. 2024 Apr;44(4):e230164. doi: 10.1148/rg.230164.

Abstract

Severe obstetric hemorrhage is a leading cause of maternal mortality and morbidity worldwide. Major hemorrhage in the antepartum period presents potential risks for both the mother and the fetus. Similarly, postpartum hemorrhage (PPH) accounts for up to a quarter of maternal deaths worldwide. Potential causes of severe antepartum hemorrhage that radiologists should be familiar with include placental abruption, placenta previa, placenta accreta spectrum disorders, and vasa previa. Common causes of PPH that the authors discuss include uterine atony, puerperal genital hematomas, uterine rupture and dehiscence, retained products of conception, and vascular anomalies. Bleeding complications unique to or most frequently encountered after cesarean delivery are also enumerated, including entities such as bladder flap hematomas, rectus sheath and subfascial hemorrhage, and infectious complications of endometritis and uterine dehiscence. ©RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material. See the invited commentary by Javitt and Madrazo in this issue.

MeSH terms

  • Cesarean Section
  • Female
  • Hematoma
  • Humans
  • Placenta
  • Postpartum Hemorrhage* / diagnostic imaging
  • Postpartum Hemorrhage* / etiology
  • Postpartum Hemorrhage* / surgery
  • Pregnancy
  • Puerperal Disorders*