Postpartum angiographic embolization for vulvovaginal hematoma: A report of two cases

J. Villella, D. Garry, G. Levine, S. Glanz, R. Figueroa, D. Maulik

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

BACKGROUND: Puerperal hematomas can become a life-threatening obstetric emergency. Their incidence is 1 or 2/1,000 deliveries. When mainstay methods of suture and packing fail, arterial embolization becomes an excellent alternative to definitive treatment, laparotomy. CASES: A 32-year-old woman, para 2-0-2-2, developed extreme rectal and vulvar pain one hour post-partum. A 12 × 10-cm vulvovaginal hematoma was identified, drained, sutured and packed. Bleeding continued, blood products were administered, and selective angiographic embolization of the pudendal and inferior gluteal arteries was successfully performed. A 31-year-old woman, para 1-0-1-1, developed a left vaginal hematoma immediately postpartum. She failed vaginal packing and underwent angiographic arterial embolization successfully. The patient was discharged on the fourth postpartum day. At six weeks postpartum, neither patient had evidence of hematoma formation. CONCLUSION: In the setting of a puerperal hematoma refractory to conventional first-line therapy, arterial embolization provides a rational, effective alternative for achieving hemostasis with minimal morbidity.

Original languageEnglish (US)
Pages (from-to)65-67
Number of pages3
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume46
Issue number1
StatePublished - Feb 13 2001

Keywords

  • Angiography
  • Embolization
  • Hematoma
  • Postpartum period
  • Therapeutic
  • Vagina
  • Vulva

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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