Retropsoas and subgluteal abscesses following paracervical and pudendal anesthesia

Retroperitoneal abscesses are uncommon in obstetrics and gynecology. Recently, seven reported cases of retropsoas-subgluteal abscesses following paracervical-pudendal anesthesia have been reported, and we have seen two additional cases. The infrequent occurrence and diagnostic difficulties make these abscesses especially dangerous. They can result in substantial patient morbidity and mortality. They must be suspected in patients receiving paracervical-pudendal anesthesia prior to vaginal delivery in whom hip pain subsequently develops. Therapy consists of prompt surgical exploration and drainage and appropriate antibiotic therapy.