Secondary PPH is any excessive bleeding from the birth canal occurring between 24 hours and 12 weeks postnatal 1 . . Despite dramatic increase in hospital deliveries secondary PPH is still common and a cause of significant morbidity to the delivered woman especially in developing countries or in a low resource setting. Incidence of secondary PPH in our study was 1.25%.Caeserian delivery is an important risk factor for secondary PPH. Initial conservative management with uterotonics is the mainstay of treatment. In our study 76 women (25.5%) were managed successfully by conservative management. Surgical evacuation was done in 221 (74.4%) women who had USG documented retained products of conception/placental polyp. 66 (22.2%) had torrential bleeding which was controlled by tamponade in 62 (20.8%) and hysterectomy had to be resorted to in 4 women. 4 post cesarean secondary PPH patients with USG documented empty uterus did not respond to conservative management and were diagnosed as cases of AV fistula / pseudoaneurysm on color Doppler.
