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Gynaecology & Obstetrics Complication of 3rd Stage of Labour b2657683

A woman complains of severe pain in vagina after vaginal delivery. O/E - she is pale, her P/R = 110 beats/minute, B/P = 100/60 mm of Hg. Vaginal examination reveals a large soft boggy mass on right lateral vaginal wall. What is the most appropriate treatment?

A
Analgesics and observation
B
Tight vaginal packing
C
Drain and insert a figure of 8 suture
D
Drain and explore for bleeding vessels
High-Yield Explanation
Ans. is c, i.e. Drain and insert a figure of 8 sutureThis patient is having soft, boggy mass on right lateral wall of vagina, i.e. she has vaginal hematoma. The hematoma has led to unstable Vitals. This is an indication for the surgical management of hematoma, i.e. put a drain and insert figure of 8 suture. Indications for the surgical management of hematoma are as follows:1. Hemodynamic instability2. Increasing size of hematoma3. Extensive pain

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