From TOLAC to Total Abdominal Hysterectomy: Perioperative Challenges in a Case of Severe Postpartum Hemorrhage

Authors

Maya Jaradi, Oakland University William Beaumont School of Medicine Medical Student
Hashim Aslam, Oakland University William Beaumont School of Medicine Medical Student
Eric Battista, Corewell Health East Resident
Roy Soto, Corewell Health East

Document Type

Conference Proceeding

Publication Date

10-11-2025

Abstract

A 31-year-old G2P1 female presented for a trial of labor after cesarean (TOLAC) and underwent a vacuum-assisted vaginal delivery. She subsequently developed hypotension, tachycardia, dizziness, nausea, and significant bleeding with numerous clots, leading to emergent OR intervention. Postpartum complications included uterine rupture, IR right uterine artery embolization for broad ligament hematoma, and ultimately, total abdominal hysterectomy due to ongoing bleeding. With an estimated blood loss of nearly 8L, she required a massive transfusion protocol. With this case, we will discuss the risks of TOLAC, the importance of early recognition of postpartum hemorrhage, and perioperative management of uterine rupture and broad ligament hematomas.

Comments

American Society of Anesthesiologists Anesthesiology Annual Meeting, October 10-14, 2025, San Antonio, TX

Recommended Citation

Jaradi M, Aslam H, Battista E, Soto R. From TOLAC to total abdominal hysterectomy: perioperative challenges in a case of severe postpartum hemorrhage. Presented at: American Society of Anesthesiologists Anesthesiology Annual Meeting; 2025 Oct 11; San Antonio, TX. Available from:https://www.abstractsonline.com/pp8/#!/21028/presentation/8302