Abstract
Broad ligament haematoma is one of the important emergencies faced in labour room with variable incidence between 1:500 and 1:20,000. It occurs due to obstetric trauma (lacerations/tear) to the cervix, upper vagina or uterus that extends into uterine or vaginal vessels or vessels of the broad ligament. The diagnosis is usually late as pain is not of a conspicuous nature and so also the vaginal bleeding. Unexplained shock with features of internal haemorrhage following delivery raises the suspicion. If not diagnosed in time, it can have fatal progress leading to maternal mortality. The definitive treatment of broad ligament haematomas is variable according to size, location and severity of patient. Thus strong clinical suspicion, prompt diagnosis and timely intervention are the important factors for successful treatment.
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References
Fliegner JR. Postpartum broad ligament haematomas. J Obstet Gynaecol Br Commonw. 1971;78:184–9.
Hankins G, Zahn C. Puerperal haematomas and lower genital tract lacerations. In: Hankins G, et al., editors. Operative obstetrics. Norwalk, CT: Appleton and Lange; 1995. p. 57–72.
Cheung TH, Chang A. Puerperal haematomas. Asia-Oceania J Obstet Gynaecol. 1991;17:119–23.
Williams JW. Subperitoneal hematoma following labor not associated with lesions of the uterus. Trans Am Gynecol Soc. 1904;29:186.
Addo V, Kokroe FA, Reindorf RL. Broad ligament haematoma following a Snake Bite. Ghana Med J. 2009;43:181–2.
Mirza FG, Gaddipati S. Obstetric emergencies. Semin Perinatol. 2009;33:97–103.
Edmonds K. Dewhurst’s textbook of obstetrics and gynecology. 6th ed. London: Blackwell Science; 1999.
Mawhinney S, Holman R. Practice points puerperal genital haematoma: a commonly missed diagnosis. Obstet Gynaecol. 2007;9:195–200.
Bloom AI, Verstandig A, Gielchinsky Y, Nadiari M, Elchalal U. Arterial embolisation for persistent primary postpartum haemorrhage: before or after hysterectomy? BJOG. 2004;111:880.
Badawy SZA, Etman A, Singh M, Murphy K, Mayelli T, Philadelphia M. Uterine artery embolization: the role in obstetrics and gynecology. Clin Imaging. 2001;25:288–95.
Dildy GA 3rd. Postpartum haemorrhage: new management options. Clin Obstet Gynecol. 2002;45:330–44.
Salomon LJ, deTayrac R, Castaigne-Meary V, Audibert F, Musset D, Ciorascu R, et al. Fertility and pregnancy outcome following pelvic arterial embolization for severe post-partum haemorrhage. A cohort study. Hum Reprod. 2003;18:849–52.
Brown BJ, Heaston D, Poulson AM. Uncontrollable postpartum bleeding: a new approach to haemostasis through angiographic arterial embolization. Obstet Gynecol. 1979;54(3):361–5.
Heffner LJ, Mennuti MT, Rudoff JC, McLean GK. Primary management of postpartum vulvovaginal haematomas by angiographic embolization. Am J Perinatol. 1985;2(3):204–7.
Chin HG, Scott DR, Resnik R, Davis GB, Lurie AL. Angiographic embolization of intractable puerperal haematomas. Am J Obstet Gynecol. 1989;160(2):434–8.
Villella J, Garry D, Levine G, Glanz S, Figueroa R, Maulik D. Postpartum angiographic embolization for vulvovaginal haematoma: a report of two cases. J Reprod Med Obstet. 2001;46:65–7.
Bienstman-Pailleux J, Huissoud C, Dubernard G, Rudigoz RC. Management of puerperal haematomas. J Gynecol Obstet Biol Reprod (Paris). 2009;38:203–8.
Goodwin SC, Walker WJ. Uterine artery embolization for the treatment of uterine fibroids. Curr Opin Obstet Gynecol. 1998;10(4):315–20.
Doumouchtsis SK, Papageorghiou AT, Arulkumaran S. Systematic review of conservative management of postpartum haemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv. 2007;62:540–7.
Sentilhes L, Gromez A, Clavier E, Resch B, Verspyck E, Marpeau L. Predictors of failed pelvic arterial embolization for severe postpartum haemorrhage. Obstet Gynecol. 2009;113:992–9.
Dahdouh EM, Balayla J, Dube J. Angiographic embolization of a postpartum vulvovaginal haematoma in a patient with situs inversus totalis: an effective second line treatment. Case Rep Obstet Gynecol. 2013;2013:323781.
Benrubi G, Neuman C, Nuss RC, Thompson RJ. Vulvar and vaginal haematomas: a retrospective study of conservative versus operative management. South Med J. 1987;80(8):991–4.
South Australian Perinatal Practice Guidelines. Puerperal genital haematomas. Adelaide: Dept of Health, Govt of South Australia; 2012.
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Korde-Nayak, V., Biniwale, P. (2020). Broad Ligament Haematoma. In: Sharma, A. (eds) Labour Room Emergencies. Springer, Singapore. https://doi.org/10.1007/978-981-10-4953-8_41
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DOI: https://doi.org/10.1007/978-981-10-4953-8_41
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