Large retroperitoneal hematoma following vaginal delivery: a case report

Autor: Raha Maroyi, Nyakio Ngeleza, Kiminyi Kalunga, Cikwanine Buhendwa, Usama Shahid, Roland Boij, Denis Mukwege
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Medical Case Reports, Vol 15, Iss 1, Pp 1-5 (2021)
Druh dokumentu: article
ISSN: 1752-1947
DOI: 10.1186/s13256-021-02870-x
Popis: Abstract Background Retroperitoneal hematoma after vaginal delivery is rare but can lead to maternal morbidity and mortality. Diagnosis of this condition is challenging due to its complexity and its nonspecific signs and symptoms. To date, studies and case reports regarding retroperitoneal hematoma are few, particularly in low-income countries where risk factors for this condition may be more prevalent and the prognosis poorer. Case presentation We report the case of a 37-year-old multiparous african (Congolese) woman who presented to the emergency department of a large referral hospital in Bukavu, Democratic Republic of the Congo (DRC), 2 weeks after a spontaneous nontraumatic vaginal delivery. She had abdominal pain that began immediately after delivery and progressed throughout the postpartum period. The patient had anemia, hypotension, tachycardia, and a left costo-lumbar arch distorting the body shape on a soft and depressed abdomen. She had visited a private clinic on days 3 and 7 postpartum; however, signs and symptoms of retroperitoneal hematoma went unrecognized. Using abdominal ultrasound, we diagnosed an extensive hematoma in the retroperitoneal space from the left iliac fossa to the left flank. Laparotomy was performed to evacuate the hematoma, and the patient recovered. Conclusion Retroperitoneal hematoma following a nontraumatic vaginal delivery is an unusual situation in general obstetrical practice. The knowledge of this potentially life-threatening condition in resource-limited settings enables effective diagnosis and management by ultrasound and laparotomy.
Databáze: Directory of Open Access Journals
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