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Laparoscopic view, looking from superiorly to inferiorly in the peritoneal cavity which has been pumped up with carbon dioxide gas to visualize the uterus (marked by blue arrows). On the left fallopian tube there is an ectopic pregnancy and hematosalpinx (marked by red arrows). The right tube is normal. Specialty: Urology
The medical definition of hematocolpos is "an accumulation of blood within the vagina". It is often caused by the combination of menstruation with an imperforate hymen. [1] [2] It is sometimes seen in Robinow syndrome, uterus didelphys, or other vaginal anomalies. A related disorder is hematometra, where the uterus fills with menstrual blood. [3]
Although hematometra can often be diagnosed based purely on the patient's history of amenorrhea and cyclic abdominal pain, as well as a palpable pelvic mass on examination, the diagnosis can be confirmed by ultrasound, which will show blood pooled in the uterus and an enlargement of the uterine cavity.
Lochia that is retained within the uterus is known as lochiostasis [9] or lochioschesis, and can result in lochiometra [10] (distention of the uterus - pushing it out of shape). Lochiorrhea describes an excessive flow of lochia and can indicate infection. [11]
A hydrosalpinx is a condition that occurs when a fallopian tube is blocked and fills with serous or clear fluid near the ovary (distal to the uterus). The blocked tube may become substantially distended giving the tube a characteristic sausage-like or retort-like shape.
A temperature rise above 38 °C (100.4 °F) maintained over 24 hours or recurring during the period from the end of the first to the end of the 10th day after childbirth or abortion. (ICD-10) Oral temperature of 38 °C (100.4 °F) or more on any two of the first ten days postpartum. (USJCMW) [12]
[8] [9] However, the case of intrauterine hematoma observed before 9 weeks of gestational age has been associated with an increased risk of miscarriage. [10] In one study women who complied with instructions for bed rest for the duration of bleeding had a lower rate of miscarriage and a higher rate of term pregnancy than non-compliant women.
Other causes include miscarriage, ectopic pregnancy, molar pregnancy, incompetent cervix, uterine rupture, and preterm labor. [31] Bleeding in early pregnancy may be a sign of a threatened or incomplete miscarriage. In the second or third trimester a placenta previa (a placenta partially or completely overlying the cervix) may bleed quite severely.