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This is an accumulation of blood within the uterus.

  • It may be caused by Müllerian duct anomalies.[1]
  • Imperforate hymen.
  • In older women, it may be secondary to carcinoma of cervix or cervical stenosis (eg following cone biopsy).
  • Other causes include infection with Listeria monocytogenes, laser endometrial ablation, uterine curettage and cervical cryocoagulation or electrocoagulation.[2, 3]
  • It may be the result of childbirth, either by normal vaginal delivery or assisted deliveries, such as forceps.
  • Acute haematometra is a rare complication following induced termination of pregnancy.[4]
  • Amenorrhoea, but there may be some menstrual blood flow.[5]
  • Lower abdominal swelling and tenderness.
  • It may present with severe primary dysmenorrhoea.
  • It may be associated with pyometra, especially after termination of pregnancy, when the patient may have a high fever and other evidence of infection.
  • If due to an imperforate hymen, and therefore associated haematocolpos develops, the hymen may bulge and exhibit a bluish discoloration. CA-125 and CA19-9 may be elevated.[6]
  • Abdominal ultrasound.
  • MRI scan may be required if the ultrasound result is unclear.

This will depend on the cause, eg imperforate hymen can be incised.

It is a rare cause of urinary tract obstruction and urinary retention.[7]

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Original Author:
Dr Colin Tidy
Current Version:
Dr Hayley Willacy
Document ID:
1022 (v22)
Last Checked:
18 February 2011
Next Review:
17 February 2016

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