When Post-Miscarriage Bleeding Doesn’t Stop

This young woman experienced post-miscarriage bleeding due to retained placenta after a 20-week miscarriage in another province.

Doctors attempted manual removal of the placenta, but it was complicated with severe bleeding. She needed two units of blood transfusion to stabilize her.

Yet, even after all that, the bleeding didn’t stop.

For two months, she continued to suffer from intermittent abnormal uterine bleeding, until she came to Lusaka seeking further care.

🔎 Diagnosis (Ultrasound with Doppler):

A vascular intrauterine mass, highly suggestive of a placental polyp.

🎥 Treatment (Intraoperative Hysteroscopy):

Direct visualization confirmed the diagnosis, and the polyp was carefully excised.

⚠️ It was one of those challenging cases that truly test your skills and patience.

The retained tissue had been inside the uterus for two months, firmly attached to the endometrium, with a real risk of significant bleeding during removal.

With precision, patience, and careful hysteroscopic guidance, we managed to remove it completely and safely.

💧 Outcome (Follow-up Ultrasound):

The uterine cavity appeared clear, with no abnormal vascularity, and the bleeding finally stopped.

🌟 Key message:

Persistent bleeding after miscarriage should never be ignored. Even months later, retained placental tissue can turn into a difficult, high-risk case.

But with timely diagnosis and minimally invasive hysteroscopy, safe recovery is possible.

Attached video of cavity after removal and ultrasound pictures of uterus before and after procedure.

✨ Update: Histopathology Results

Histopathology confirmed the diagnosis as retained products of conception (RPOC) with chorionic villi and decidual tissue showing degenerative changes.

This reinforces the importance of:

Always considering placental polyp / RPOC in cases of persistent post-miscarriage bleeding.

Using ultrasound + hysteroscopy not only for diagnosis but also as definitive treatment.

💙 Another reminder that timely intervention prevents complications and restores health.

#DrRababCares 

#PlacentalPolyp 

#Histopathology 

#WomensHealthMatters 

#Hysteroscopy

#ForestParkHospital