The Iranian Journal of Obstetrics, Gynecology and Infertility

The Iranian Journal of Obstetrics, Gynecology and Infertility

Retroperitoneal hematoma following uncomplicated normal delivery: case report

Document Type : Case report

Authors
Leila Pourali 1
Atiyeh Vatanchi 2
Behzad Aminzadeh 3
Samira Armanpour 4
1 Associate Professor, Department of Obstetrics and Gynecology, Fellowship of Pelvic Floor Disorders, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijogi.2022.20801
Abstract
Introduction: Postpartum pelvic hematomas are classified as vulvovaginal, paravaginal and retroperitoneal hematomas. Retroperitoneal hematoma is the most uncommon condition after normal vaginal delivery. In the present study, a rare case of large retroperitoneal hematoma after uncomplicated vaginal delivery is reported.
Case presentation: The patient was a 25-year-old woman P1L1 who was admitted to a university hospital of Mashhad in July 2021 for pregnancy termination due to preeclampsia. She developed dizziness while walking 24 hours after uncomplicated normal vaginal delivery. CT-scan showed large retroperitoneal hematoma.
Conclusion: In the case of any abnormal findings in vital signs after delivery, the diagnosis of pelvic hematomas, especially large retroperitoneal hematoma, should be considered. Prompt diagnosis and treatment of this complication can reduce the risk of maternal morbidity and mortality.
Keywords
Hematoma
Normal vaginal delivery
Preeclampsia
Retroperitoneal space
  1. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25nd ed. New York: McGraw-Hill Education; 2018.
  2. Rafi J, Muppala H. Retroperitoneal haematomas in obstetrics: literature review. Archives of gynecology and obstetrics 2010; 281(3):435-41.
  3. İskender C, Topçu HO, Timur H, Oskovi A, Göksu G, Sucak A, et al. Evaluation of risk factors in women with puerperal genital hematomas. The Journal of Maternal-Fetal & Neonatal Medicine 2016; 29(9):1435-9.
  4. Nelson EL, Parker AN, Dudley DJ. Spontaneous vulvar hematoma during pregnancy: a case report. The Journal of Reproductive Medicine 2012; 57(1-2):74-6.
  5. Alturki F, Ponette V, Boucher LM. Spontaneous retroperitoneal hematomas following uncomplicated vaginal deliveries: a case report and literature review. Journal of Obstetrics and Gynaecology Canada 2018; 40(6):712-5.
  6. Bulbul M, Iner H, Nacar MC, Karacor T. Retroperitoneal Hematoma after Birth due to Iliac Vascular Injury: a Case Report and Review of Literature. SN Comprehensive Clinical Medicine 2019; 1(10):850-3.
  7. Mousavi Seresht L, Rouhalamin S, Khalili Borujeni T. A Medical Error Leading to Retroperitoneal Hematoma Following Normal Delivery: A Case Report. Isfahan Medical School 2021; 39(614):121-5.
  8. Baruch A, Stentz NC, Wallett SM. Retroperitoneal hemorrhage presenting as a vaginal hematoma after a spontaneous vaginal delivery. Int J Gynaecol Obstet 2015; 130(2):201-2.
  9. Zilan M, Korkmazer E, Seyfi M, Temur M, Çift T, Üstünyurt E. Postpartum retroperitoneal pelvic hematoma. Journal of The Turkish German Gynecological Association 2016; 17:S328.
  10. Ali J, Konyak P. Large haematoma in uterovesical pouch following vaginal delivery. New Indian J OBGYN 2017; 3(2):111-3.
  11. Maroyi R, Ngeleza N, Kalunga K, Buhendwa C, Shahid U, Boij R, et al. Large retroperitoneal hematoma following vaginal delivery: a case report. Journal of Medical Case Reports 2021; 15(1):1-5.
  12. Takeda A, Koike W, Imoto S, Nakamura H. Three-dimensional computerized tomographic angiography for diagnosis and management of intractable postpartum hemorrhage. European Journal of Obstetrics & Gynecology and Reproductive Biology 2014; 176:104-11.
  13. Cichowski S, Rogers RG. Managing complications of perineal lacerations. Contemporary Ob/Gyn 2017; 62(9):22.
  14. Mukhopadhyay D, Jennings PE, Banerjee M, Gada R. Ultrasound-guided drainage of supralevator hematoma in a hemodynamically stable patient. Obstetrics & Gynecology 2015; 126(6):1188-90.
  15. Fahimuddin FZ, Seid A, Agrawal A. Successful management of a supralevator intraperitoneal puerperal hematoma with angiographic embolization. Proceedings in Obstetrics and Gynecology 2019; 9(1).
  16. Rafi J, Khalil H. Maternal morbidity and mortality associated with retroperitoneal haematomas in pregnancy. JRSM open 2018; 9(1):2054270417746059.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 5
July 2022
Pages 109-113