关键词: 产后出血, 破裂, 自发性, 分娩, 产道, 腹腔镜检查, 病例报告

Abstract:

Postpartum hemorrhage is a common complication during delivery. However, postpartum hemorrhage caused by broad ligament laceration during vaginal delivery is rare. A 28-year-old primigravida was admitted to the hospital with 39⁺⁵ weeks of stopping menstruation, no signs of labor awaiting delivery. There was no abnormality in the past medical history, and the pregnancy examination was normal and spontaneous vaginal delivery with an uneventful labor. Four hours after delivery, the patient presented symptoms and signs such as vomiting, pale face, increased heart rate, decreased blood pressure, decreased hemoglobin, and non-clotting blood extracted by abdominal puncture, which were diagnosed as abdominal hemorrhage. We performed emergency small incision combined with gasless laparoscopy and found a rupture in the left broad ligament. Vascular clamp was used to clamp the blood vessel and suture the broad ligament. The operation was successful and the prognosis was good. Through the review and study of the above case, it is concluded that in order to choose the right way of delivery, the prenatal need to fully evaluated the physical condition of the pregnant women, pelvic conditions and fetal conditions. During vaginal delivery, attention should be paid to guide pregnant women to exert proper force and avoid excessive pressure. In case of postpartum hemorrhage, it is necessary to identify symptoms and signs as early as possible and make proper treatment. Laparotomy or laparoscopic exploration is the key when it is difficult to diagnose bleeding in hidden areas (broad ligament, etc.).

Key words: Postpartum hemorrhage, Rupture, spontaneous, Labor, obstetric, Laparoscopy, Case reports