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Re: Incidence of labial hematoma From: WD McIntosh (wdmcintoshmd@pol.net) Thu Aug 6 16:15:35 1998 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J. Woolley: "Re: Norplant" Previous message: Robert J. Woolley: "Re: Incidence of labial hematoma" -----Original Message----- From: LynneDoll@aol.com <LynneDoll@aol.com> To: Multiple recipients of list <ob-gyn-l@talk.obgyn.net> Date: Thursday, August 06, 1998 1:20 PM Subject: Re: Incidence of labial hematoma >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????? I was called in by a junior resident when I was the chief resident for a similar situation. No particular trauma, no episiotomy, no repair, but a large (5-6cm) hematoma about 45 minutes after delivery. We never found any "pumpers", but I am surprised the patient did not die of Vicryl poisoning it took so much to stop the oozing. My personal opinion, unencumbered by data, is that the distention of the head coming out treads that very fine line wherein the dispensability of the subcutaneous tissue is exceeded, and that of the epidermis is not. After all, skin is generally stronger than the connective tissue under it. William D. McIntosh, MD Clarksville, TN Next message: Robert J. Woolley: "Re: Norplant" Previous message: Robert J. Woolley: "Re: Incidence of labial hematoma"

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