Ultrasound-Guided Urokinase in the Remedy of Spontaneous Vaginal Hematoma After Vaginal Delivery: A Case Report

INTRODUCTION: Vaginal hematoma is commonly treated by traditional incision and sutures. In this report, we describe the treatment of a spontaneous vaginal hematoma after vaginal delivery by ultrasound-guided urokinase injection. CASE PRESENTATION: A 32-year-old multipara developed a spontaneous vaginal hematoma after vaginal delivery. The hematoma diagnosed via ultrasound examination of the postpartum pelvic basin was located in the posterior vaginal wall, and measured to be 8.92 × 5.71 cm from transvaginal ultrasonography. After considering the size and position of the hematoma, treatment by urokinase injection under ultrasound guidance was selected and performed three times. Forty-two days after the last treatment, the hematoma had disappeared. DISCUSSION AND CONCLUSION: For patients in stable condition, when incision and sutures of vaginal hematoma after natural delivery is difficult to perform, urokinase injection under ultrasound guidance can be an effective treatment method that helps in the absorption of the hematoma.