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ISSN 2073-8137

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Risk of massive blood loss in postpartum vaginal hematoma

[Original research] [Obstetrios and gynecology]
Vladislava Novikova; Evgenia Aseeva; Natalya Uglova; Vadim Khorolsky; Karina Filina; F Kazibekova;

Bleeding in the postpartum period poses a threat to the woman’s life. Vaginal hematomas of 10.1±3.6 cm in the size can be asymptomatic at the onset, which may cause underestimation of the total blood loss in women with postpartum hemorrhage due to a variety of other competing causes. The use of analgesia in labor hinders timely diagnosis of postpartum hematomas of vagina, perineum or defects in hemostasis in the area of episiotomy stitches or suturing of soft tissue ruptures in the birth canal. The present study investigated 120 women with varicose veins of the lower extremities, their median age being 24.2±5.12, the gestational age at delivery – 38.20±1.09 weeks. In order to timely diagnose postpartum hematomas in the vagina, the perineum or hemostasis defects in the area of episiotomy stitches or suturing of soft tissue ruptures in the birth canal, 2 hours after the labor women underwent transperineal ultrasound study of the vagina (Ultrasound Scanner PHILLIPS HD-11). Vaginal hematomas were detected in 31 (25.8 %) women, and only 10 (8 %) women had damage to the mucous layer of the vaginal wall, while in 21 (17 %) women this was not the case. None of the women revealed any complaint typical of patients with hematomas.


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Keywords: postpartum hemorrhage, massive blood loss, vaginal hematoma

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy