A medical error leading to retroperitoneal hematoma following normal delivery: A case report

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. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.