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Re: Incidence of labial hematomaFrom: Robert J. Woolley (wooll005@tc.umn.edu)Thu Aug 6 16:06:15 1998
In message <bf198612.35c9f1c1@aol.com> writes: > Yesterday my partner delivered a 7#4oz baby from an Oriental woman. There > was > no episiotomy and no laceration (she had an epidural). At 30 minutes after > the birth she complained of pain in her perineal region. The CNM examined > her > and found a large (14cm) hematoma of the right labia. She was taken to > surgery where three "pumping" vessels were ligated, the hematoma evacuated > and > a JP drain placed. In my 19 years of practice as a CNM I have never seen a > hematoma on intact perineum. Any thoughts?????
>From my review article (now at http://www.gentlebirth.org/format/woolley.html): g. Edema and hematoma As with infection, the incidence of postpartum hematoma did not change with the dropping episiotomy rate in Reynolds and YudkinÕs hospital [9]. Rckner et al reported significantly higher rates of both edema and hematoma (25% and 38%, respectively) after episiotomy than after second- and/or third-degree lacerations (8% and 13%) [64]. Weijmar Schultz et al [68] concurred with the increase in hematoma after episiotomy (rates not reported), but saw no difference in edema. Harrison et al [43] found that the severity of both of these conditions was similar between women with episiotomy and spontaneous second-degree tear. The Argentine Episiotomy Trial Collaborative Group measured only hematoma; rates were about 4% in both trial arms [49]. 6) Neither liberal nor restrictive use of mediolateral episiotomy has convincingly been shown to increase rates of postpartum perineal infection, edema, or hematoma. ---------------------------------------------------------------------------
--------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota
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