A Medical Error Leading to Retroperitoneal Hematoma Following Normal Delivery: A Case Report

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 upper part and posterior lateral of vagina in vaginal exam was suspicious to retroperitoneal hematoma, and emergent laparotomy confirmed the diagnosis.

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.