[Hematoma of the parametrium due to birth trauma]

From 1973 to 1980, assisting 59,068 vaginally completed deliveries, the authors encountered 19 hematomas of the parametrium (0.032%). Labour was prolonged in 13 out of these 19 cases and the instruments applied were the outlet forceps in 6 and the vacuum extractor in 2 cases, while the expulsion of the child in 5 cases was helped by an intravenous injection of Syntocin. Half the parturients were in the third and half in the fourth decade of their life; a third of them were primiparae. Clinically the picture of atony or uterine rupture prevailed. In the development of the hematoma of the parametrium a large number of etiological factors are to be pointed out: birth injury, parity, age, predisposition, and others. In 6 women subtotal hysterectomy, in 4 the ligature of the uterine artery, and in 5 the evacuation of the hematoma were applied, while in the remaining ones the treatment as conservative.