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What causes hematoma post c-section? - Online Doctor Chats

Date : 06-Apr-2014
User rating for this question
Very Good Posted in: Skin Hair and Nails
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User:I had a planned C-sect on Oct. 18, 2013, and had some hemorrhaging afterwards that was controlled with uterine massage and three infusions of Oxytocin and an injection of methergine.I developed a hematoma about apple-sized just below my umbilicus while still in the hospital.At my follow up visit (6 weeks) with my OB doctor,I expressed concern about the hematoma, as it had not decreased in size.She suggested that it may take 6 months for it to reabsorb.I have now had 3 menstrual cycles (which are heavier than before pregnancy) and the hematoma has not changed or may even be slighter bigger.I am concerned that it may be more than a hematoma or something that needs drained?I also am a registered nurse!
Doctor:Hi
User:hello
Doctor:Give me a moment to read your query
Doctor:ok
Doctor:I have read your query
Doctor:It is an unusual case
Doctor:of developing a hematoma post c-section
User:I thought so too...my doctor did make mention of the possibility of a hernia, but no imaging studies have been ordered.
Doctor:As in all cysts and lumps. I think an ultrasound may be done to see its contents and its source
Doctor:If it is hernia. it must be having a source
Doctor:If it is just a plain cyst it can be drained...which is diagnostic and threapeutic
User:yes, it is also much more noticeable when I am standing than when I lie down
Doctor:Is it reducible?
User:no
Doctor:Have you tried deep palpation to check for its source?
User:but does not hurt, just causes pressure sometimes
Doctor:ok
User:yes, i have tried palpation but can't seem to find the bottom of it, it seems fairly superficial and a little high to be uterine in nature
User:it is a couple inches above my C-sect incision
Doctor:ok
Doctor:Then it may either be in skin or fascia
User:what would be the cause of something like that?
Doctor:It mostly happens as a result of trauma
Doctor:In your case it developed as a result of incision
Doctor:Most hematomas resolve spontaneously
User:how long should i give it then? It has been almost 5 months...
Doctor:Sometimes they may spread
Doctor:You can always ask for an ultrasound
Doctor:but if it is hematoma for sure then it will resolve
Doctor:I think it is time to ask for ultrasound
User:will ultrasound be able to differentiate between hematoma and hernia?
Doctor:It may also be an abscess
Doctor:yes
Doctor:definitely
User:I was worried about an abscess but have had no signs of infection...
Doctor:Even hematomas can cause fever
Doctor:Do you have any?
User:no fevers
Doctor:ok
Doctor:Is it above the rectus muscle or below it?
User:above
Doctor:ok
Doctor:It is of superficial variety
User:seems to be...when I stand I can see the location it sticking out, an uneven mass
Doctor:After ultrasound you may check with your doctor if it can be drained
User:ok, i will make an appointment with my primary care doctor...my OB doc is out on maternity leave, which confounds the problem!
Doctor:A hematoma means that a blood vessel is bleeding
Doctor:ok
Doctor:Your gp should be able to take care of it
User:ok.. thanks
Doctor:ok
Doctor:Do you have any other question?
User:no thank you so much
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