Bilateral Massive Hematoma of Bartholin Glands after Prolonged Labour: A Case Report
Puerperal hematoma is a rare complication which might develop after delivery and
which might put the mother’s life in danger if not recognized in time.
Statistically, the incidence of puerperal hematoma widely varies
between 1/300 and 1/1500 deliveries while the rate of cases necessitating
surgical treatment is almost 1/900 cases.
Most often, puerperal hematomas develop in the peri-vaginal or peri-vulvar spaces,
in the lax tissues, tending to widely dissect the spaces where no anatomical obstacle is present.
At this level, due to the high levels of pregnancy hormones
there is a limited possibility of spontaneous haemostasis;
secondarily, the hematoma might dissect
the peri-vaginal and peri-rectal spaces, ascending to the retroperitoneal space.
The most common localizations are the vaginal, vulvar and pelvic ones.
We present the case of a 27-year-old primiparous patient who developed
a massive bilateral vulvar hematoma after a prolonged labour followed
by a Ceasarian section, associated with perineal debilitating pain, fever and difficulties in defecation.
The hematoma proved to be entirely developed into the Bartholin glands, which were irreversibly compromised.
A total bilateral resection of Bartholin glands was performed.
A 27-year-old primiparous woman referred herself to Obstetrics clinic during the 39th
week of gestation for sustained uterine contractions; the local examination revealed
a quasicomplete cervical dilation; after a negative labour test the patient was submitted to a Caesarean section.
Three days after surgery the patient reported the apparition of two tumoral,
renitent lesions with vulvar localization, with mass effect on the distal vagina and anal canal.
The clinical examination revealed that the anterior perineal region was significantly tumefied
and very painful when touched.
Gynecol Obstet Res Open J. 2015; 2(3): 77-79. doi: 10.17140/GOROJ-2-116
