Obstetrical treatment of retroplacental hematoma based on the clinical observation of 12 cases

Based on a critical review of the specialized literature and on the analysis of 12 personal cases, the author develops a few considerations on the obstetrical treatment of retroplacental hematoma. Once the diagnosis of RPH has been established in 12 cases, the hypovolemia, anemia (possibly hemorrhagic shock), coagulation disorders are corrected and an abdominal caesarean section is performed. In 2 cases, the caesarean section was followed by a hemostatic hysterectomy, and in one of these 2 cases, a bilateral ligation of the hypogastric arteries was also performed. With the current advances of intensive treatments, the risk induced by caesarean section is much less severe than the one which could incur from a calculated delay. Emergency caesarean section reduces this delay and represents a prophylaxis of fetal and maternal complications (which may be sudden and irreversible, because of the unpredictable extension of the RPH).