Sonographically diagnosed pelvic hematomas and postcesarean febrile morbidity

Objective: To evaluate the incidence of ultrasonographically-diagnosed post cesarean hematomas and correlate their presence with febrile morbidity. Met hods: Prospective study of 111 consecutive patients who had a pelvic ultras ound 4-6 days post-operatively. Ultrasonographic findings were correlated w ith clinical data. Results: Postoperative fever was diagnosed in 28 (25%) p atients. Fifteen (13.5%) women had hematomas; 10 (9%) had bladder-flap and five (4.5%) had subfascial hematomas. Only subfascial hematomas were signif icantly associated with post-operative fever (P = 0.01). Conclusions: Postc esarean bladder-flap hematomas are not predictive of post-operative fever. The presence of subfascial hematomas should be specifically sought in the e valuation of a febrile postcesarean patient. (C) 1999 International Federat ion of Gynecology and Obstetrics.