2014 Volume 66 Issue 1 Pages 1-5
Vulvar or paravaginal hematomas are important causes of puerperal hemorrhage. These sometimes extend into retroperitoneal space, forming retroperitoneal hematomas that are difficult to treat. We analyzed the cases of vulvar or paravaginal hematoma at our hospital between January 2010 and December 2011. Nineteen cases of hematoma (0.8%) were experienced among 2215 cases of term vaginal delivery. Among them, six cases (0.2%) were transferred to tertiary medical centers. Primiparity was identified as a significant risk factor for these hematomas (p<0.05). Birth weight of delivered infants and maternal weight gain among the hematoma cases was significantly lower than those in non-hematoma cases (p<0.05). In the 12 of 13 cases not transferred to the tertiary medical centers, hematomas developed in the same region as vaginal lacerations. In the five of six serious cases transferred to the tertiary centers, in contrast, hematoma developed without laceration of superficial vaginal tissues. In such case, identification of hematomas tends to be delayed, resulting in more serious developments. The possibility that a hematoma may develop without laceration of superficial vaginal tissues should be considered. [Adv Obstet Gynecol, 66 (1) : 1-5, 2014 (H26.2)]
