Symptoms of postpartum hematoma

Postpartum hematoma is a common symptom. Most postpartum hematomas in women are caused by rupture of blood vessels in the birth canal when the fetus is delivered from the mother's body. If the blood cannot flow out in time, it is easy to cause hematoma. Generally speaking, women with postpartum hematoma need to be well cared for after delivery so that the body can slowly recover. What are the symptoms of postpartum hematoma?

Symptoms of birth canal hematoma

The symptoms of birth canal hematoma mainly include swelling of the labia, swelling of the buttocks near the anus, and swelling of the inner part of the vagina. In addition, according to the different parts of the hematoma, it is mainly divided into vulvar hematoma, vaginal hematoma, vulvovaginal hematoma, and retroperitoneal hematoma.

1. Vulvar hematoma: Vulvar hematoma can be found to be local swelling of the vulva of the parturient through naked eye observation, the vulva skin or mucosa is purple, and the hematoma is confined to the vulva of the parturient. This situation is mainly caused by improper suturing technique during birth canal laceration or episiotomy repair, incomplete hemostasis, and retraction of the leaked blood vessels so that no bleeding can be seen at the time.

2. Vaginal hematoma: Vaginal hematoma is difficult to detect from the outside, and is also called hidden hematoma. The redness and swelling are mainly concentrated in the tissues near the vagina. There are no obvious symptoms in the first parturient, but symptoms of local swelling and pain in the vagina appear later. It often occurs in women who are in emergency labor.

3. Vulvovaginal hematoma: Hematoma occurs in the vagina, perineum, ischiorectal fossa, etc.

4. Retroperitoneal hematoma: After bleeding from the soft birth canal, it can spread to the retroperitoneum along the broad ligament. When the amount of bleeding is large, it can reach the pelvic diaphragm fascia downward and the kidney area upward, causing hematoma in the spread part. It often occurs in women who have cervical lacerations or whose incisions during cesarean section extend to the parauterine vessels and are improperly sutured.

Causes of birth canal hematoma

1. Primiparas: Primiparas are the group with the highest incidence of birth canal hematoma clinically. Because the perineum and vagina of primiparas are relatively tight, the vagina will expand rapidly during delivery, which can easily cause rupture of blood vessels in deep tissues and subsequently form hematomas. In addition, when the fetal head is hard and difficult to deform, the huge impact when the fetus is delivered can easily cause perineal lacerations in primiparas, and the wound may extend to form a hematoma.

2. Pregnancy complicated with hypertension syndrome: During delivery, women with pregnancy complicated with hypertension syndrome often experience systemic arteriolar spasm, which leads to increased peripheral vascular resistance and endothelial cell damage. At the same time, various tissues and organs suffer from ischemia and hypoxia, microvascular damage and increased vascular fragility, leading to birth canal hematoma.

3. Coagulation dysfunction: If the mother has a genetic disease of coagulation dysfunction, during pregnancy, the number of platelets will be small and the quality will be relatively poor. When the birth canal is injured and bleeding occurs, there are not enough platelets to produce coagulation function, resulting in a low coagulation rate, easy escape of red blood cells, and spontaneous bleeding and hematoma. This situation is common in pregnant women with hepatitis.

4. Too rapid labor: Some women in emergency labor experience a drop in the fetal head before the soft birth canal is fully dilated. During the descent of the fetal head, the impact force generated can directly cause damage to the soft birth canal tissue or tear deep blood vessels, leading to the formation of birth canal hematoma. In addition, the position of the fetal head can also affect the location of birth canal hematoma. If it is left occipital anterior position (the fetal head is facing the left front of the mother's pelvis), hematoma is prone to occur on the right side of the mother's vagina; occipital posterior position (the back of the fetal head is facing the mother's spine) often causes hematoma on the anterior wall of the mother's vagina.