Gynecology & Obstetrics
Open Access

Spontaneous broad ligament hematoma following normal vaginal delivery

5^th Asia Pacific Gynecology and Obstetrics Congress

August 22-23, 2018 Tokyo, Japan

Dheeraj Yalla, Alka and Usha Rani

Sri Ramachandra University, India

Scientific Tracks Abstracts: Gynecol Obstet

Abstract :

Broad ligament hematoma is a rare complication following a normal vaginal delivery. We report one such case of a woman who developed this complication within 3 hours of normal vaginal delivery. She is G2P1L1, 38 weeks GA, in active labor. Patient was allowed for spontaneous progression of labor, following which she delivered vaginally. Within 3 hours patient looked clinically very pale with vitals being deranged and complains of inability to void urine, severe perineal pain. On basis of clinical examination and trans-abdominal ultrasound features a diagnosis of right sided broad ligament hematoma was made. Based on patients hemodynamic instability surgical management in the form of obstetric hysterectomy was done. Broad ligament hematoma is a relatively uncommon complication that can occur following a spontaneous vaginal delivery. It can be silent and not cause any obvious vaginal bleeding. Clinical symptoms are vague with persistent perineal pain, urge to defecate, unable to void within first few hours of delivery. Imaging modalities like trans-abdominal ultrasound and MRI can help in confirming the diagnosis. It has been suggested that MRI depicts postpartum hemorrhage even in deep extra-peritoneal regions where the hematoma is clinically non-apparent and in addition it can delineate the extent of the hematoma. Broad ligament hematoma can be managed both conservatively and surgically depending on patient hemodynamic status, size and rate of hematoma expansion. Small non spreading ones can be managed conservatively however larger ones might need internal iliac artery ligation, UAE or even hysterectomy. Our patient was hemo-dynamically unstable after confirmed diagnosis and given the circumstances that the hematoma was expanding we decided on the surgical management i.e. subtotal hysterectomy.

Biography :

Dheeraj Yalla is currently pursuing his Post Graduation in MS (Obstetrics and Gynecology) in Sri Rama Chandra Medical College, Chennai. He has completed his MBBS from Andhra Medical College, King George Hospital, Visakhapatnam in 2015. He is currently doing his research on the maternal highly sensitive C reactive protein as predictor of pre-eclampsia.

E-mail: yalladheeraj@yahoo.co.in