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Une cause rare d’hémorragie du post-partum: le thrombus génital
We report the case of a 30-year old primiparous patient, having given birth to a 3500g boy by cesarean section due to acute fetal distress. Two hours after childbirth, the patient had bilateral painful ecchymotic vulvar swelling suggesting post-partum thrombus of the vulva. Given the clinical stabil...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The African Field Epidemiology Network
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814950/ https://www.ncbi.nlm.nih.gov/pubmed/31692783 http://dx.doi.org/10.11604/pamj.2019.33.241.18359 |
Sumario: | We report the case of a 30-year old primiparous patient, having given birth to a 3500g boy by cesarean section due to acute fetal distress. Two hours after childbirth, the patient had bilateral painful ecchymotic vulvar swelling suggesting post-partum thrombus of the vulva. Given the clinical stability of the size of this hematoma, the absence of unbearable pain and the stable hemodynamic status, conservative medical treatment (ice bag + NSAIDs). Output was favorable with progressive decrease in the size of the hematoma until disappearance 8 weeks after delivery. Thrombus or genital hematoma is a rare but potentially very serious post-partum haemorrhagic complication. There are four major types of genital hematomas: hematoma of the vulva, vulvo-vaginal hematoma, vaginal hematoma and pelvic-abdominal hematoma. The contributing factors are primiparity, instrumental extractions, toxaemia of pregnancy, twin pregnancies and vulvovaginal varicose veins. It is essential to suspect it in patients with pain and/or internal postpartum hemorrhage, and, if any doubt exists, to perform vulvovaginal inspection. Early treatment is necessary and should be associated with hemodynamic resuscitation, first-line surgery and percutaneous radiologic arterial embolization in case of failure of surgery. |
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