Hematoma espontáneo del ligamento ancho luego de un parto vaginal normal: reporte de caso / Spontaneous hematoma of the broad ligament after a normal vaginal delivery: case report / Hematoma espontâneo do ligamento largo após um parto vaginal normal: apresentação de um caso clínico

La hemorragia posparto es una de las principales causas de muerte materna con una elevada morbimortalidad. El hematoma del ligamento ancho representa una entidad inusual, de difícil diagnóstico y alta sospecha clínica. Se presenta el caso clínico de una paciente con un hematoma del ligamento ancho espontáneo luego de un parto vaginal. Se optó por una conducta activa con laparotomía y antibioticoterapia obteniendo una buena evolución con egreso hospitalario a los 30 días. Se realiza la discusión del caso luego de revisar la bibliografía disponible.

Postpartum hemorrhage is one of the main causes of maternal death with high morbidity and mortality. The broad ligament hematoma represents an unusual entity, difficult to diagnose, in which clinical suspicion is determinant. The clinical case of a patient with a spontaneous broad ligament hematoma after a vaginal delivery is presented. An active management with laparotomy and antibiotic therapy was chosen, obtaining a satisfactory evolution with hospital discharge at 30 days. The case is discussed, after reviewing the available bibliography.

A hemorragia pós-parto é uma das principais causas de morte maternal com alta morbidade e mortalidade. O hematoma do ligamento largo representa uma entidade incomum, de difícil diagnóstico e alto suspeita clínica. A presentamos o caso clínico de uma paciente com hematoma espontâneo do ligamento largo, após parto vaginal. Foi optada por conduta ativa com laparotomía e antibioticoterapia, obtendo boa evolução com alta hospitalar após 30 dias. O caso é discutido depois de revisar a bibliografia disponível.

Bilateral femoral neuropathy after vaginal delivery: A case report / 대한마취과학회지

Epidural analgesia is frequently used for the management of labor pain in parturients. The neurologic complications of epidural analgesia are rare, but they are catastrophic when they occur. We report here on a case of bilateral femoral neuropathy in a vaginal delivery patient with epidural analgesia. The patient complained of weakness of both thighs and numbness around both knees. Neurologic examination and electromyographic study revealed that they occurred due to the delivery itself. The patient had not fully recovered at eight weeks after delivery. The declining incidence of postpartum femoral neuropathy may reflect a reduced duration of labor in accordance with modern obstetric practice, and particularly the more frequent use of Caesarean delivery. The exact etiology of postpartum femoral neuropathy is unknown, and the possible factors are direct compression of nerves that are proximal within the pelvis by either the fetal head or birthing instruments, or this malady is the result of pressure induced ischemia at the level of the inguinal ligament when the pregnant woman is in the lithotomy position.