A Medical Error Leading to Retroperitoneal Hematoma Following Normal Delivery: A Case Report

10.22122/jims.v39i614.13705

Abstract

Background: Retroperitoneal hematomas, as a rare but significant quantity in patients with history of recent operation, should be suspected in all patients who demonstrate signs of hypovolemia without apparent blood loss. Here, we have presented a rare case of postpartum hematoma to aware about this diagnosis in similar cases.
Case Report: A 24-year-old gravid 1 woman with term pregnancy had tachycardia and oliguria after delivery with large episiotomy extended up to right fornix. After volume resuscitation, a tense tender swelling in the posterior lateral part of vagina had been detected in vaginal examination, suspicious to retroperitoneal hematoma, what was confirmed in emergent laparotomy.
Conclusion: Post-vaginal delivery laceration extending from posterior vaginal wall to uterosacral ligament and rarely to para-vesical space can be a life-threatening emergency and a cause of maternal mortality. Careful examination and repair of extended episiotomy or laceration is the key factor to prevent retroperitoneal hematoma.

Keywords


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