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[Postpartum intra-abdominal haemorrhage--case report]
Aleksandra Petrić1, Radomir Zivadinović, Aleksandra Tubić Pavlović
1Ginekolosko-akuserska klinika, Klinicki centar Nis, Nis. sidunja@bankerinter.net
Introduction:
The most frequent cause of gynaecological haemoperitoneum is ruptured ectopic pregnancy. Haemoperitoneum after a normal vaginal delivery is rare and it is associated with high maternal mortality.
Case Report:
A 22-year-old primipara had a normal vaginal delivery. She experienced acute abdominal pain and hypovolemic shock ten hours after the delivery and was referred to our hospital twenty one hours after the delivery. An urgent ultrasound profile was done, which revealed free fluid in pelvis and in the whole abdomen. An immediate laparotomy was done and 2 litres of blood were found within the peritoneal cavity. The uterine wall was intact. We found a haematoma on the anterior wall of rectum and livid colours of broad ligament. The peritoneal cavity was cleaned and revised. Any injury of the spleen or liver was excluded.
Discussion And Conclusion:
Haematoperitoneum after a normal vaginal delivery is rare but life threatening to mothers. It is important to recognize this condition to avoid delay in diagnosis and treatment because of high maternal mortality. Our patient was bleeding from superficial rectal vessels. Only a few cases with undefined aetiologies have been reported in literature.
