SUBINVOLUTION OF THE PLACENTAL SITE AS THE CAUSE OF

HYSTERECTOMY IN YOUNG WOMAN

Summary

According to the case report published by Triantafyllidou et al. (2021), the subinvolution

of placental sites (SPSs) is a rare but severe cause of secondary postpartum

hemorrhage (PPH). Subinvolution of the placental site refers to delayed or inadequate

physiologic closure and sloughing of the superficial modified spiral arteries at the

placental attachment site. Subinvolution can be identified and documented by the

typical clinical features and the histologic findings in postpartum endometrial curetting

and hysterectomy specimens. Subinvolution of the placental site is commonly

associated with delayed postpartum or post-abortal hemorrhage. It tends to occur in the

older group of obstetrical patients and in multipara. The case presented was a

secondary PPH in a young woman after uncomplicated cesarean delivery who was

deemed clinically unstable, and finally, underwent an emergent total abdominal

hysterectomy. The authors reviewed the literature with an emphasis on the

pathophysiology of this situation. Unfortunately, the exact pathogenesis of SPS is still

unknown.