Postpartum Hemorrhage: Placenta Accreta, Uterine Inversion, and Puerperal Hematomas

Zahn, Christopher M.; Yeomans, Edward R.

doi:10.1097/00003081-199009000-00006

Cited by 62 publications

(45 citation statements)

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“…The rapid emptying of the uterus as in this case has also been suggested as a possible predisposing [4]. Other recognized risk factors include excessive fundal pressure, relaxed uterus, fundal placenta and short umbilical cord [5]. Diagnosis is clinical and for complete inversion, a mass is palpated or seen at the introitus.…”

Section: Discussionmentioning

confidence: 75%

Complete Uterine Inversion Managed With a Rusch Balloon Catheter

Uzoma

2010

J Med Cases

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Acute uterine inversion is a rare but very serious obstetric emergency which is highlighted by this case report. Risk factor here was the rapid labor with first to third stage lasting only 45 minutes and associated active pushing in the third stage. Even with the hallmark of massive post-partum hemorrhage, quick intervention resulted in adequate resuscitation. A modified hydrostatic method of reduction using the Rusch balloon catheter repositioned the uterus while serving the additional role of managing any further post-partum hemorrhage. The outcome was good due to multi-disciplinary cooperation, prompt management and senior involvement.

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Section: Discussionmentioning

confidence: 75%

Complete Uterine Inversion Managed With a Rusch Balloon Catheter

Uzoma

2010

J Med Cases

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“…The most common factor associated with puerperal hematoma is episiotomy. 1 Vaginal lacerations, usually related to instrumental deliveries, can also lead to hematoma formation. Instrumental delivery itself is a risk factor, even in the absence of a laceration.…”

Section: Discussionmentioning

confidence: 99%

“…Other putative risk factors for hematoma formation are pressure necrosis, inadequate hemostasis at the time of tissue repair, primiparity, preeclampsia, multiple gestation, vulvovaginal varicositis, a prolonged second stage, and clotting abnormalities. 1 Puerperal hematomas may be classified as vulvar, vaginal, vulvovaginal, or retroperitoneal. Vulvar hematomas most often result from injuries to branches of the pudendal artery, including the posterior rectal, transverse perineal, or posterior labial artery, while vaginal hematomas may result from injuries to the descending branch of the uterine artery.…”

Section: Discussionmentioning

confidence: 99%

“…Its incidence ranges from 1 per 300 to 1 per 1,500 deliveries. 1 The English literature contains little information about the role of sonography and other imaging techniques in the management of puerperal hematomas. In a recent review, Salvo 2 described the sonographic findings of several postpartum complications, including extraperitoneal hematomas, but did not specifically describe vulvovaginal hematomas.…”

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confidence: 99%

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Puerperal vulvovaginal hematoma: Sonographic findings with MRI correlation

Guerriero

Ajossa

Bargellini

et al. 2004

J of Clinical Ultrasound

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Puerperal hematomas are a major complication of delivery. Little information about the role of sonography in the management of puerperal hematomas is available in the English literature. We report a case of a vulvovaginal hematoma that developed subsequent to vaginal delivery and that was managed conservatively using sonography. Our report includes the sonographic follow-up of the lesion with MRI correlation. The present case report suggests that sonography has a role in the detection and follow-up of the condition, with MRI providing a more detailed mapping of the lesion and excluding any retroperitoneal involvement.

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“…1,2 Statistically, the incidence of puerperal hematoma widely varies between 1/300 and 1/1500 deliveries while the rate of cases necessitating surgical treatment is almost 1/900 cases. [3][4][5][6] Most often, puerperal hematomas develop in the peri-vaginal or peri-vulvar spaces, in the lax tissues, tending to widely dissect the spaces where no anatomical obstacle is present. At this level, due to the high levels of pregnancy hormones there is a limited possibility of spontaneous haemostasis; secondarily, the hematoma might dissect the peri-vaginal and peri-rectal spaces, ascending to the retroperitoneal space.…”

mentioning

confidence: 99%