Title: Trans-Uterine Seldom Approach for Repair of Extensive Vaginal Tears Not Accessible Through Conventional Route: A Case Report
Authors: Dr Shrinivas N. Gadappa, Dr Pratibha V. Dixit, Dr Sonali Deshpande
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.112
Abstract
Background: Obstetric hemorrhages are the most common cause of maternal morbidity and mortality in developing countries. Traumatic postpartum hemorrhage (PPH) secondary to high vaginal wall tear is a rare but life-threatening complication of vaginal delivery.
Case Report: We discuss a 20-year-old P1L1 female who had full-term vaginal delivery and was referred to our hospital from a peripheral hospital due to continuous vaginal bleeding after delivery. She had a high posterior vaginal wall laceration that was bleeding profusely, and the apex was not traceable vaginally. We successfully managed the tear through abdominal exploration with bilateral internal iliac artery ligation followed by a trans-uterine approach.
Conclusion: Cervicovaginal tears are seldom sutured through a transuterine approach. This case described a successful correction that avoided the use of obstetric hysterectomy.
Keywords: Traumatic PPH, Internal iliac artery ligation.
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