Introduction: Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, with uterine atony being its most common etiology. Rare pathological placental abnormalities, such as chorangiosis, may contribute to the occurrence and severity of PPH, although reports on this association are scarce. In this study, a case of severe postpartum hemorrhage with treatment-resistant atony due to placental chorangiosis is reported.
Case Presentation: We report a case of a 27-year-old primigravid woman (G₁) at 38 weeks and 4 days of gestation who underwent an emergency cesarean section due to oligohydramnios and breech presentation. Following the delivery of a healthy newborn, the patient developed severe uterine atony refractory to standard therapeutic measures and ultimately required a subtotal hysterectomy due to massive hemorrhage. Histopathological examination of the placenta revealed chorangiosis. After stabilization of hemodynamic status and intensive care management, the patient was discharged in good general condition.
Conclusions: This case suggests a possible association between placental chorangiosis and severe refractory PPH. Awareness of this rare placental condition may help clinicians anticipate life-threatening complications and optimize management strategies.