25 year old female patient is referred from a PHC with history of expanding vulvar mass, during first hour post partum. She delivered normally and without perineal laceration. She complains of severe pain. On examination her BP is 90/40 mmHg, pulse = 130bpm and no fever. what is your approach in treatment of patient
Severe pain and expanding hematoma are indication of immediate surgical exploration.
Ice packs placed and plan observation.
Angiographic embolization of supra levator hematoma.
Incise the point of maximum expansion, evacuate clots, and ligate bleeding points.
Laparotomy to evacuate retroperitoneal hematoma as it is connected to ischioanal fossa.