Spontaneous intraperitoneal rupture of a postpartum rectus sheath haematoma

A Tertiary Center Case Series on Postpartum Rectus Sheath Hematoma: An Unveiled Identity

Rectus sheath hematoma is a well-recognized, uncommon clinical entity and may not be the initial consideration when evaluating a postpartum patient with abdominal pain or mass. Here, we report three cases of postpartum rectus sheath hematomas (RSH) managed during the last three years. The mean age of the patient was 28 (25-30) years. All patients had a history of cesarean section and presented with pain and distension in the abdomen. The cesarean was performed eight days, one day, and three days in cases 1, 2, and 3, respectively, before presentation to the hospital. Two (Cases 1 and 3) of the three patients received conservative care and were discharged in stable condition. One patient (Case 2) who was operated on for RSH and hemoperitoneum expired due to multiorgan dysfunction syndrome (MODS). Our case series suggests that, depending on the severity of the hematoma and the hemodynamic condition of the patient, RSHs may require medical intervention ranging from conservative management to surgical treatment. Early diagnosis and intervention help prevent hazardous complications and prevent maternal morbidity and mortality.