Abdominal compartment syndrome resulting from postpartum hematoma of wall: a rare occurrence associated with a high risk of mortality

Abstract

Objective of current study was to analyze and summarize the clinical features of postpartum abdominal hemorrhage with Abdominal Compartment Syndrome (ACS) to improve its diagnosis and treatment. A retrospective analysis of the clinical data of four cases of postpartum abdominal hemorrhage with ACS treated in our hospital from 2009 to 2014. Postpartum ACS is characterized by excessive blood loss. Symptoms mainly included oliguria, abdominal distention, shortness of breath, progressive decrease in hemoglobin and hematocrit, coagulation disorders, large volumes of ascites on computed tomography and B-type ultrasonography, and significant increases in intra-abdominal pressure. All four patients underwent surgical decompression and hemostasis, including one case of intestinal necrosis caused by ACS. Two patients fully recovered, while two patients died: one due to acute respiratory distress syndrome and one from lupus encephalopathy. Postpartum hemorrhage can lead to abdominal ACS, which is life-threatening. Physicians should attach great importance to timely diagnosis of this phenomena and early surgical decompression is key to successful treatment.