{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:38Z","timestamp":1787017058335,"version":"build-2736575974"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,16]]},"abstract":"<jats:p>A 34-year-old woman presented to hospital in shock 8\u2009hours after a spontaneous home vaginal delivery. She is a known carrier of haemophilia A. Examination revealed a tender but firm, central and contracted uterus. There was a small second-degree perineal tear which was not actively bleeding and no other trauma or bleeding visualised in the vault or cervix. Bedside ultrasound showed a large 1\u2009L blood clot anterior to the empty uterus. Exploratory laparotomy was performed which revealed a haematoma in the Retzius space with extension beneath the anterior serosa of the bladder, through the left broad ligament and into the retroperitoneal space. Bleeding from the Santorini plexus was controlled with haemostatic sutures, reinforced with FLOSEAL and intra-abdominal packing. A CT angiogram and relook laparotomy the following day confirmed haemostasis and facilitated removal of intra-abdominal packs. This case demonstrates a very rare cause of postpartum retroperitoneal haemorrhage.<\/jats:p>","DOI":"10.1136\/bcr-2018-225980","type":"journal-article","created":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T12:11:17Z","timestamp":1535544677000},"page":"bcr-2018-225980","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Retzius space haematoma as a rare cause of concealed retroperitoneal postpartum haemorrhage following spontaneous vaginal delivery"],"prefix":"10.1136","volume":"2018","author":[{"given":"Melissa Louise","family":"Acreman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahesh","family":"Sainani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,29]]},"reference":[{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.1","doi-asserted-by":"crossref","first-page":"e156","DOI":"10.1016\/j.ejogrb.2016.07.391","article-title":"Scoring system & challenges of concealed massive Postpartum Haemorrhage (PPH)","volume":"206","author":"Hirsi-Farah","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.2","doi-asserted-by":"crossref","first-page":"205427041774605","DOI":"10.1177\/2054270417746059","article-title":"Maternal morbidity and mortality associated with retroperitoneal haematomas in pregnancy","volume":"9","author":"Rafi","year":"2018","journal-title":"JRSM Open"},{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.3","first-page":"159","article-title":"[Mixed endoscopic colposuspension (retroperitoneal and vaginal) for the treatment of female stress urinary incontinence: technique and preliminary results]","volume":"26","author":"Salvat","year":"1998","journal-title":"Contracept Fertil Sex"},{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.poamed.2015.03.004","article-title":"Retzius space haematoma with retroperitoneal dissection after spontaneous vaginal delivery: an unusual presentation of ruptured paravesical plexus managed by bilateral internal iliac artery ligation","volume":"22","author":"El-agwany","year":"2015","journal-title":"Polish Annals of Medicine"},{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.5","first-page":"175","article-title":"Retzius' space haematoma after spontaneous delivery: a case report","volume":"76","author":"Fieni","year":"2005","journal-title":"Acta Biomed"},{"key":"2025042706045300000_2018.aug29_1.bcr-2018-225980.6","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1365-2516.2007.01561.x","article-title":"Pregnancy in carriers of haemophilia","volume":"14","author":"Chi","year":"2008","journal-title":"Haemophilia"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225980","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:05:03Z","timestamp":1745744703000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,29]]},"references-count":6,"alternative-id":["10.1136\/bcr-2018-225980"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225980","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,29]]}}}