Spontaneous Orbital Hematoma: A Rare Complication of Vaginal Delivery

Background: Nontraumatic orbital hemorrhage is a rare complication after labor with only 12 cases reported in the literature. We describe a new case of a spontaneous, nontraumatic orbital hematoma after an uncomplicated vaginal delivery. Methods: Retrospective clinical case. Results: A 34-year-old healthy woman, gesta2 para1, complains, after an uncomplicated, term, vaginal delivery, of left ocular pressure associated with double vision. On physical examination, an orbital asymmetry with left eye proptosis and inferior deviation was observed. Ophthalmological examination revealed a left vertical diplopia with normal visual acuity (10/10, bilaterally). Pupils were reactive with no papilledema. Orbital CT diagnosed a homogeneous, hyperdense lesion with 6.5 × 25 × 34 mm on the left upper orbit, suggestive of hematoma (Figure 1). Orbital/cranial MRI, performed two days later, confirmed an intraorbital, extra-conic acute hematoma with 7 mm (maximum diameter), imposing inferior deviation of left ocular globe. Expectant management was adopted and one month after all symptoms and signs had disappeared. Conclusions: Complete regression of orbital hematoma with conservative treatment strongly supports the diagnosis of nontraumatic orbital hemorrhage. *Corresponding author: Sara Nunes, Department of Gynecology & Obstetrics, Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, Portugal, Tel: 00351915418111 Check for updates pressure during maternal expulsive efforts [2,3]. Though the relationship of orbital hemorrhage after Valsalva Maneuver is well known, it is important to bring awareness of this pathology to healthcare professionals, especially to those who provide obstetric care, since visual complains may be associated with severe obstetric complications such as pre-eclampsia/ eclampsia, which should be excluded. We present a new case of a spontaneous, orbital hematoma on a healthy woman, after an uncomplicated, term, vaginal delivery.