Analysis of puerperal hematoma: a retrospective study

Objective: To evaluate the characteristics and risk factors of puerperal hematoma. Materials and Methods: Data from the medical records of 2,776 women, who delivered vaginally between January 2008 and December 2017 in the authors' hospital, were analyzed retrospectively. Results: Primigravida status was considered to be a significant risk factor. Among women with multigravida status, maternal age, instrumental delivery, and episiotomy were considered to be statistically significant risk factors. Regarding characteristics, hematoma occurred on the right side in 61.5% of cases, 53.8% were ≥50 mm in size, 61.5% were detected within 2 h of delivery, 46.2% were associated with severe pain, and 61.5% required surgical treatment. Conclusion: Primigravida status a risk factor for puerperal hematoma, and maternal age, instrumental delivery, and episiotomy were risk factors for puerperal hematoma in women with multigravida status. Puerperal hematomas occurred more frequently on the right side than the left reflected by the number of episiotomies performed on the right side. Approximately one-half of the hematomas were associated with severe pain, and many were detected within 2 h after delivery. Many hematomas, especially those associated with severe pain, required surgical removal.