TITLE:
Spontaneous Paravesical and Broad Ligament Hematoma after Vaginal Delivery Had Uterine Artery Embolization after Evacuating the Hematoma
AUTHORS:
Aayat Jaaffar Naseeb, Abrar Majdi Al Nasheet
KEYWORDS:
Broad Ligament, Paravesical Hematoma, Spontaneous Hematoma, Uterine Artery Embolization, Retroperitoneal Hematoma, Vaginal Delivery
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.14 No.3,
March
29,
2024
ABSTRACT: Broad ligament hematoma is typically seen during cesarean section due to
rupture of branches of uterine and vaginal vessels and it’s rare to be seen
post-normal vaginal delivery. Addressing puerperal hematomas postpartum
presents considerable challenges for obstetric care providers. While hematomas
such as those affecting the vulva, vulvovaginal region, or paravaginal area are
frequently encountered, retroperitoneal hematomas are rare and notably pose a
greater risk to the life of the patient. The medical literature contains scant
case reports on retroperitoneal hematomas, with no consensus on a definitive
treatment approach. Pelvic arterial embolization has emerged as both a sensible
and increasingly preferred method for treating these hematomas recently, but
its application is contingent upon the patient maintaining hemodynamic
stability and the availability of a specialized interventional embolization
unit. In our case, we are presenting a very rare case of a 31-year-old primigravida
female with a history of in vitro fertilization pregnancy. She delivered a
normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced
multiple complications intrapartum, including preeclampsia and placental
abruption. These complications increased her risk of developing a broad
ligament hematoma.