F.F. MINNULLINA^1, 2, L.M. MUKHAMETZYANOVA^1, 2, L.R. AKHMETSHINA²

 ¹Kazan (Volga) Federal University, Kazan

²Republic Clinical Hospital, Kazan

 Contact details:

Minnullina F.F. — PhD (medicine), Associate Professor of the Department of Surgical Diseases, Leading Researcher, Head of the Gynecology Department

Address: Orenburgskiy trakt 138, Kazan, Russian Federation, 420064, tel.: +7-987-233-04-78, e-mail: minnullina_f@mail.ru

Postpartum retroperitoneal hematomas can occur both after surgical and normal vaginal delivery. Etiology includes mechanical and spontaneous causes. If a retroperitoneal hematoma is suspected, it is necessary to carry out urgent diagnostic measures with the participation of a multi-speciality team to develop a plan for the patient management and treatment. Surgical intervention or conservative treatment is performed depending on the clinical situation. The continuing instability of hemodynamics is an indication for surgical intervention (revision of the abdominal cavity, intra-arterial embolization, puncture, etc.). This article presents two clinical cases of combined conservative treatment and uterine artery embolization of patients with this pathology. In both cases the treatment was effective.

Key words: postpartum hematoma, retroperitoneal hematoma, postpartum complications.

REFERENCES

1. DavydovaIu V., Krivorchuk I.G., Ogorodnik A.A., Leshchishin I.M., Naumchik A.N. Retroperitoneal obstetric hematomas. Ukrainian Journal of Perinatology and Pediatrics, 2020, vol. 2 (82), pp. 92–97. DOI: 10.15574/PP.2020.82.92
2. Aylamazyan E.K. Morphofunctional assessment of the lower segment of the uterus at the end of physiological pregnancy and in pregnant women with a scar. Zhurnal akusherstva i zhenskikh bolezney, 2006, no. 4, pp. 11–17 (in Russ.).
3. Gurtovoy B.L., Kulakov V.I., Voropaeva S.D. Primenenie antibiotikov v akusherstve i ginekologii [The use of antibiotics in obstetrics and gynecology]. Moscow: Triada-Kh, 2004. 176 p.
4. Glukhov E.Yu. Sovremennye aspekty diagnostiki, lecheniya, profilaktiki i organizatsii meditsinskoy pomoshchi pri tyazhelykh infektsionno-vospalitel’nykh i gemorragicheskikh oslozhneniyakh pozdnego poslerodovogo perioda [Modern aspects of diagnosis, treatment, prevention and organization of medical care for severe infectious-inflammatory and hemorrhagic complications of the late postpartum period]. Ekaterinburg, 2016.
5. Yokoe T., Kita M., Fukuda H., Butsuhara Y., Sumi G., Okada H. Successful minimally invasive surgery for postpartum retroperitoneal hematoma complicated by an infection: Two case reports. Ann Med Surg (Lond), 2021, vol. 71, p. 103025. doi: 10.1016/j.amsu.2021.103025. PMID: 34840771; PMCID: PMC8606833.
6. Maroyi R., Ngeleza N., Kalunga K., Buhendwa C., Shahid U., Boij R., Mukwege D. Large retroperitoneal hematoma following vaginal delivery: a case report. J Med Case Rep., 2021, vol. 15 (1), p. 290. DOI: 10.1186/s13256-021-02870-x PMID: 34024285; PMCID: PMC8142484.
7. Yokoe T., Kita M., Suzuki K., Butsuhara Y., Yoshida A., Morikawa M., Okada H. Laparoscopic hemostasis and drainage for postpartum retroperitoneal hematoma complicated with an infection: A case report and surgical video. Ann Med Surg (Lond), 2022, vol. 77, p. 103686.
8. Acreman M.L., Sainani M. Retzius space haematoma as a rare cause of concealed retroperitoneal postpartum haemorrhage following spontaneous vaginal delivery. BMJ Case Rep., 2018. DOI: 10.1136/bcr-2018-225980. PMID: 30158271; PMCID: PMC6119360.
9. Gupta R., Pokharia P., Daspal U., Ammar H. Laparoscopic treatment of postpartum pre-sacral haematoma. J Minim Access Surg, 2021, vol. 17 (2), pp. 265–267. DOI: 10.4103/jmas.JMAS_153_20. PMID: 33723187; PMCID: PMC8083755.