Vaginal delivery related hempothorax:Report of two cases

A hemothorax is a condition that results from blood accumulation in the pleural cavity. By far, the most common cause of hemothorax is trauma. However, a number of nontraumatic causes or spontaneous hemothorax may occur. Here are two cases of hemothorax during the immediate postpartum vaginal delivery period. Both cases were in term and admitted to hospital because of vaginal delivery. One case was complicated with sudden hypotension and cyanosis during transferring to delivery room. Delivery induction was preceded for both cases and vaginal delivery followed with continuity of vaginal bleeding, because of uterine inertia in one and cervical rupture in the other. Both cases were managed with massive transfusion of packed cell and FFP. Respiratory distress was progressed in both cases and CXRs were demonstrated pleural effusion. Diagnostic thorasynthesis was compatible with hemothorax in both cases. Chest tube was inserted for evacuation of blood and bloody effusion was taken out, and both patients fell in good condition after 6 hours. Despite the continuity of coagulopathy, the blood drainage was stopped and chest tube pulled out after 48 hours. The possible thesis is the rupture of engorged pleural vessels during forced vaginal delivery in well muscular young women’s. In addition, induced coagulopathy or other abnormalities of pleura result in exacerbating the blood accumulation. It is logical to have in mind the less aggressive vaginal delivery and prevent coagulopathy to prevent the condition.