FEATURES OF THE POSTPARTUM PERIOD IN WOMEN WITH HEMATOMETRA

Hematometra is a pathological condition defined by the accumulation of blood within the uterine cavity resulting from partial or complete obstruction of uterine outflow. Although hematometra is well documented in general gynecological practice, its occurrence in the postpartum period remains insufficiently studied and is frequently underdiagnosed due to substantial overlap between pathological manifestations and normal puerperal physiological changes (1,2). During the early puerperium, physiological uterine involution and lochia discharge may mask the clinical presentation of hematometra, leading to delayed diagnosis and an increased risk of infectious, hemorrhagic, and subinvolution-related complications (6). The objective of this study was to analyze the clinical features, etiological factors, and diagnostic characteristics of hematometra in women during the postpartum period. A clinical observational analysis was conducted among postpartum patients diagnosed with hematometra based on comprehensive clinical evaluation and instrumental investigations. Data collection included assessment of presenting symptoms, physical examination findings, laboratory parameters, and imaging results. Ultrasonography served as the primary diagnostic modality, while additional imaging techniques were selectively applied to differentiate hematometra from retained products of conception and other postpartum uterine pathologies (3,8). The analysis demonstrated that the most common clinical manifestations of postpartum hematometra were progressive lower abdominal or pelvic pain, delayed uterine involution, and a marked reduction or complete cessation of lochia. In a subset of patients, secondary postpartum hemorrhage and systemic inflammatory signs were observed. Ultrasonographic evaluation typically revealed an enlarged uterine cavity containing heterogeneous or hypoechoic echogenic material consistent with retained blood, without evidence of active vascularization. Early recognition of these findings enabled timely therapeutic intervention, including conservative pharmacological management, cervical canal dilation, or minimally invasive uterine evacuation, resulting in favorable clinical outcomes and rapid symptom resolution.