title: Ultrasound-Guided Drainage of Supralevator Hematoma in a Hemodynamically Stable Patient.
abstract: BACKGROUND
  Paravaginal hematomas can be life-threatening. In patients with intact vaginal walls and perineum, they may pose a diagnostic and therapeutic challenge. Supralevator hematomas are much less common than infralevator hematomas.
  
  
  METHODS
  We present a case of puerperal hemorrhagic shock after a normal vaginal delivery in a low-risk parous woman resulting from an occult supralevator hematoma. Because the woman was hemodynamically unstable initially, she underwent a vaginal surgical drainage. A week later, the supravaginal hematoma reformed. At this time the patient was hemodynamically stable, and ultrasound-guided drainage was performed, which resulted in complete resolution of the hematoma within 10 days.
  
  
  CONCLUSIONS
  In a clinically stable puerperal patient, ultrasound-guided drainage of a supralevator hematoma resulted in rapid and complete resolution of symptoms.
authors.affiliation: Departments of Obstetrics and Gynecology and Radiology, Ipswich Hospital NHS Trust, Ipswich, United Kingdom.
authors.forename: Debjani
authors.initials: D
authors.lastname: Mukhopadhyay
authors.forename: Paul E
authors.initials: PE
authors.lastname: Jennings
authors.forename: Mamta
authors.initials: M
authors.lastname: Banerjee
authors.forename: Ruta
authors.initials: R
authors.lastname: Gada
mesh_terms: D000328:Adult; D004322:Drainage / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D059952:Pelvic Floor Disorders / Q000175:diagnosis / Q000628:therapy*; D011644:Puerperal Disorders / Q000175:diagnosis / Q000628:therapy*; D012771:Shock, Hemorrhagic / Q000175:diagnosis / Q000628:therapy*; D018084:Ultrasonography, Interventional