A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review

Abstract Objective We report a rare case of spontaneous bilateral perineal hematoma during pregnancy. We analyze its etiology, clinical features, treatment, and prognosis to provide a reference for clinical practice. Methods Detailed clinical information was collected, including the patient’s pregna...

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Main Authors: Yu Wang, Hongchen Liu, Ye Lu
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-025-07413-6
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author Yu Wang
Hongchen Liu
Ye Lu
author_facet Yu Wang
Hongchen Liu
Ye Lu
author_sort Yu Wang
collection DOAJ
description Abstract Objective We report a rare case of spontaneous bilateral perineal hematoma during pregnancy. We analyze its etiology, clinical features, treatment, and prognosis to provide a reference for clinical practice. Methods Detailed clinical information was collected, including the patient’s pregnancy course, delivery process, imaging findings, and subsequent pregnancy outcomes. We discuss the potential mechanisms, management principles, and prognosis of spontaneous perineal hematoma during pregnancy in light of relevant literature. Results The patient began self-administered perineal massage at 36 weeks of gestation. At 39^+5 weeks, before delivery, bilateral spontaneous perineal hematomas developed. A left mediolateral episiotomy was performed during delivery. After conservative postpartum treatment, the hematomas gradually resolved, and the wound healed well. Eighteen months later, the patient had another vaginal delivery without reoccurrence of perineal hematoma or laceration. Conclusions Spontaneous perineal hematoma during pregnancy is rare. Its occurrence may be related to increased vascular fragility, venous congestion, and external forces. Although perineal massage in pregnancy may affect perineal tissues, there is no definitive evidence of a direct causal relationship with spontaneous hematoma. Proper guidance on correct technique and force is advised.
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spelling doaj-art-69cbee3aae02491191b45cf3cd23aec22025-08-20T03:39:58ZengBMCBMC Pregnancy and Childbirth1471-23932025-03-012511710.1186/s12884-025-07413-6A case report of spontaneous bilateral perineal hematoma during pregnancy and literature reviewYu Wang0Hongchen Liu1Ye Lu2Department of Obstetrics and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Reproductive Medicine, Peking University First HospitalDepartment of Obstetrics and Reproductive Medicine, Peking University First HospitalAbstract Objective We report a rare case of spontaneous bilateral perineal hematoma during pregnancy. We analyze its etiology, clinical features, treatment, and prognosis to provide a reference for clinical practice. Methods Detailed clinical information was collected, including the patient’s pregnancy course, delivery process, imaging findings, and subsequent pregnancy outcomes. We discuss the potential mechanisms, management principles, and prognosis of spontaneous perineal hematoma during pregnancy in light of relevant literature. Results The patient began self-administered perineal massage at 36 weeks of gestation. At 39^+5 weeks, before delivery, bilateral spontaneous perineal hematomas developed. A left mediolateral episiotomy was performed during delivery. After conservative postpartum treatment, the hematomas gradually resolved, and the wound healed well. Eighteen months later, the patient had another vaginal delivery without reoccurrence of perineal hematoma or laceration. Conclusions Spontaneous perineal hematoma during pregnancy is rare. Its occurrence may be related to increased vascular fragility, venous congestion, and external forces. Although perineal massage in pregnancy may affect perineal tissues, there is no definitive evidence of a direct causal relationship with spontaneous hematoma. Proper guidance on correct technique and force is advised.https://doi.org/10.1186/s12884-025-07413-6PregnancySpontaneous perineal hematomaPerineal massagePersistent occiput posterior
spellingShingle Yu Wang
Hongchen Liu
Ye Lu
A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
BMC Pregnancy and Childbirth
Pregnancy
Spontaneous perineal hematoma
Perineal massage
Persistent occiput posterior
title A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
title_full A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
title_fullStr A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
title_full_unstemmed A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
title_short A case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
title_sort case report of spontaneous bilateral perineal hematoma during pregnancy and literature review
topic Pregnancy
Spontaneous perineal hematoma
Perineal massage
Persistent occiput posterior
url https://doi.org/10.1186/s12884-025-07413-6
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