Recurrent Massive hemorrhage from Cesarean Scar defect: a case report and literature review

Cesarean section (CD) is one of the most common operations in the world. Cesarean scar defect (CSD), one of the recently discovered complications of cesarean section, has been found to be related to abnormal uterine bleeding. Massive hemorrhage caused by CSD has rarely been reported. The cause is still unknown, and the treatments vary.We report a case of a 37-year-old woman who experienced prolonged menstruation for 6 years after her second cesarean section. She had recurrent sudden massive hemorrhage and nothing abnormal was observed by ultrasound or MRI examination except for CSD. The patient underwent hysteroscopic surgery. The abnormal uterine bleeding was successfully stopped, and the menstrual cycle returned to normal after surgical treatment. Diverticulum with abnormal bleeding symptoms may induce massive hemorrhage. Patients with the same syndrome should be informed of the risk. Hysteroscopy surgery could be a choice.