Paravaginal hematomas; their recognition and management postpartum

Paravaginal hematoma is an unavoidable obstetrical complication, usually due to the traction and rupture of paravaginal veins by the oncoming presenting part. Pain, swelling, ecchymosis and urinary retention are the usual symptoms if the hematoma is located below the levator plate, while supralevator hematomas give no external manifestations. Early diagnosis could be made more often if digital examination of the pelvis were done routinely after the third stage of labor and before dismissal of the patient from the hospital, and done more frequently in postpartum patients with pelvic complaints. Active surgical intervention is advocated to avert needless destruction of tissue, prolonged morbidity, and delayed recovery.