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Indian Journal of Maternal-Fetal & Neonatal Medicine

Volume  12, Issue 1, Jan-June 2025, Pages 29-32
 

Case Report

Spontaneous Broad Ligament Hematoma Following Vaginal Delivery: Multidisciplinary Management of Hypovolemic Shock and Multi-Organ Dysfunction

Uma Thombarapu1, Raveena Nagaram2

1 Department of Obstetrics and Gynecology, N.R.I Medical College, Chinnakakani, Guntur, Andhra Pradesh 522503,   India.  2 Resident, Department of Obstetrics and Gynecology, N.R.I Medical College, Chinnakakani, Guntur 522503, Andhra  Pradesh, India.  

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DOI: 10.21088/ijmfnm.2455.8621.12125.5

Abstract

Background: Broad ligament hematomas are rare, but potentially life-threatening complications following vaginal delivery. This can cause concealed hemorrhage and hemodynamic instability, necessitating prompt diagnosis and intervention. Effective management often requires a multidisciplinary approach to prevent maternal morbidities and mortalities. Case: An 18-year-old woman developed a large broad ligament hematoma and hypovolemic shock following a normal vaginal delivery. She was transferred to our tertiary care center on postpartum day one with persistent hypotension, requiring intensive resuscitation and uterine artery embolization. Her condition was further complicated by acute renal failure, disseminated intravascular coagulation (DIC), and respiratory distress, necessitating intubation, multiple blood product transfusions, and hemodialysis. The patient recovered completely with aggressive multidisciplinary management involving interventional radiology, critical care, and nephrology.  Conclusion: Early recognition of concealed hemorrhage and timely uterine artery embolization along with coordinated nephrology and critical care support ensured complete recovery. This case underscores the importance of a multidisciplinary approach for managing complex PPH with broad ligament hematomas and multi-organ dysfunction
 


Keywords : • Postpartum hemorrhage • Broad ligament hematoma • Hypovolemic shock • Uterine artery embolization • Acute renal failure
Corresponding Author : Raveena Nagaram,