[A rare case of retroperitoneal hematoma following injury to the pudendal artery during vaginal delivery].

BACKGROUND

Postpartum hemorrhage is an obstetric emergency that can lead to significant maternal morbidity and mortality. The common etiologies, which account for 95% of cases, include uterine atony, retained placental tissue, and vaginal and cervical tears. There are additional rare etiologies, and in these cases, diagnosis and treatment may be delayed, potentially leading to hemorrhagic or hypovolemic shock, and even maternal death. This case report describes a rare complication that occurred during a vaginal delivery.

OBJECTIVES

We present a 25-year-old woman who developed significant postpartum bleeding, after her first delivery that did not cease with initial management. Her evaluation and treatment involved a multidisciplinary team, advanced imaging, surgical intervention, interventional radiology, and a massive blood product transfusion. After an extensive evaluation, a pudendal artery injury was demonstrated, which led to a significant retroperitoneal hematoma.

CONCLUSIONS

This case highlights the rare occurrence of vascular injury as a cause of postpartum hemorrhage. It underscores the importance of timely and accurate diagnosis, rapid treatment, and multidisciplinary collaboration, all of which contributed to saving the patient's life.