Hematometra Formation- A Rare Complication of Cesarean Delivery

Kaur, Gurpreet; Jain, Sandhya; Sharma, Abha; Vaid, Neelam

doi:10.7860/jcdr/2014/8364.4689

Cited by 4 publications

(6 citation statements)

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“…Hematometrocolpos is a very rare complication following cesarean delivery, with only a few reports of hematometra existing in the literature [ 4 – 7 ]. Our patient experienced cervical and vaginal lacerations during the cesarean procedure, which were repaired abdominally.…”

Section: Discussionmentioning

confidence: 99%

“…A separate case likely resulted from inadvertent suturing of the anterior and posterior uterine walls during hysterotomy repair, which created a uterine pouch that did not communicate with the vagina [ 5 ]. Uterine compression sutures and postoperative endometritis have also been associated with postcesarean hematometra [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Iatrogenic cases of hematometrocolpos are rare but have been reported after radiation therapy [ 1 , 2 ] and vaginal deliveries causing obstetric trauma resulting in vaginal/labial adhesions [ 1 – 3 ]. Few cases of hematometra following cesarean section have been reported in the literature [ 4 – 7 ]; however, hematometrocolpos following cesarean section has not been yet been described, and the incidence is unknown. Most cases of hematometrocolpos are seen in adolescents, as a result of abnormal development of the lower genital tract.…”

Section: Introductionmentioning

confidence: 99%

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Hematometrocolpos following Low Transverse Cesarean Delivery Complicated by Uterine Dehiscence

Gabby

McDaniel

Gordon

et al. 2021

Case Reports in Obstetrics and Gynecology

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Background. Hematometrocolpos is a rare complication following procedures performed on the female genital tract. While usually seen in adolescents with congenital anomalies including imperforate hymen and vaginal stenosis, it has also been described following obstetric vaginal lacerations. The incidence following cesarean delivery is unknown. Case. This is a 43-year-old multigravida who underwent a low transverse cesarean delivery complicated by uterine dehiscence, as well as cervical and vaginal lacerations. The repair resulted in lower genital tract obstruction. She presented seven months afterwards with severe abdominopelvic pain and secondary amenorrhea, which resolved after vaginal dilation and excision of the vaginal scar. Conclusion. Systematic inspection of the upper vagina should be undertaken following complicated cesarean delivery with vaginal extension. Hematometrocolpos after cesarean delivery should be managed similar to a transverse vaginal septum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hematometrocolpos following Low Transverse Cesarean Delivery Complicated by Uterine Dehiscence

Gabby

McDaniel

Gordon

et al. 2021

Case Reports in Obstetrics and Gynecology

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“…Again during caesarian section procedure when attempting to arrest acute uterine blood loss by applying multiple hemostatic sutures material at the placental bed in a case of placenta previa section can lead to synechiae formation, cervical stenosis, and haematometra [13]. Inappropriate closure of anterior and posterior wall of the uterus during lower segment Cesarean scar can create a uterine pouch and lead to haematometra [14].…”

Section: Discussionmentioning

confidence: 99%

A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair

Lilungulu

Mwibea²,

Nassoro³

et al. 2017

Case Reports in Obstetrics and Gynecology

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Background. Haematometra is a rare postobstetrics fistula surgical repair outcome complication; however the condition can be misinterpreted especially in limited resource areas that lack routine ultrasound guidance and with a slowly progressed increase in size of abdomen accompanied with a history of amenorrhoea together with a history of having unprotective sexual intercourse which may increase the possibility of being controversial to full-term gravid uterus. The causes of haematometra might be either due to congenital abnormality of the vaginal canal or acquired iatrogenically. However, any other cause that involved vaginal canal can be a predisposing factor of haematometra. We present a case of a 32-year-old female patient, who had obstetric fistula which was successfully repaired over the past two years. She presented with one-year-and-two-month history of an amenorrhoea that was progressive accompanied with distended abdomen to the extent of looking typically as the gravid uterus. Explorative laparotomy was performed successfully and surgical incision managed by hysterotomy and salpingotomy, whereby approximately ten liters of serosanguinous blood fluid mixed with blood clots was completely suctioned. Despite being a rare condition after vesicle vaginal fistula repair complication outcome, haematometra remains to be relatively common gynaecological condition among female adolescence during postpubertal period.

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“…In other reports of hematometra, there were additional risk factors to help increase the index of suspicion. One case reported a post-cesarean section hematometra due to uterine adhesion surrounding the internal cervical os [6], and another reported hematometra as a result of leiomyoma obstruction of the uterine outflow tract [5]. …”

Section: Discussionmentioning

confidence: 99%

Acute abdominal pain caused by hematometra in an adolescent female: a case report

2016

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BackgroundHematometra is a pathologic collection of blood in the uterus. It is a rare condition that is most commonly associated with congenital anomalies or prior surgical procedures causing an obstruction of the genitourinary outflow tract. We present an unusual case of hematometra in a healthy and active adolescent female with no prior risk factors. This is a rare and important case report due to the complexity of diagnosis when a young female presents with an acute abdomen. In addition, for a patient who presents with no prior risk factors for hematometra, such as in our patient, the diagnosis and workup may become overly complicated, adding strain to patient care and health care cost. To the best of our knowledge and based on an extensive literature search, there has not been a reported case of hematometra in an adolescent female without any aforementioned risk factors.Case presentationOur patient is a healthy 18 year-old white woman with no significant prior medical or surgical history. Her only medication was depot medroxyprogesterone acetate use for contraception. She presented to a local emergency department with acute abdominal pain, accompanied by emesis and nausea. Workup with ultrasonography showed uterine distention most likely caused by hematometra, although no obvious cause was noted. She was treated with dilation and curettage; she was also advised to discontinue depot medroxyprogesterone acetate use. She was symptom free without recurrence of hematometra at 6-month follow-up.ConclusionsDue to the high prevalence of abdominal pain, this case report has a wide breadth of implications for health care providers ranging from general family practitioners to emergency room physicians and obstetricians/gynecologists. This case report provides potential future advancement in management and differential diagnosis in adolescent females presenting with acute abdominal pain. In addition, the use of depot medroxyprogesterone acetate contributing to or causing hematometra cannot be ruled out in our patient and warrants further investigation.

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Hematometra Formation- A Rare Complication of Cesarean Delivery

Cited by 4 publications

References 4 publications

Hematometrocolpos following Low Transverse Cesarean Delivery Complicated by Uterine Dehiscence

Hematometrocolpos following Low Transverse Cesarean Delivery Complicated by Uterine Dehiscence

A Case of Haematometra Secondary to Cervical Stenosis after Vesicle Vaginal Fistula Surgical Repair

Acute abdominal pain caused by hematometra in an adolescent female: a case report

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