Sarah Anyango K., 18

Sarah is the second-born in her family and lives with her single mother, two siblings, and her firstborn child in a small two-room mud-walled house. She dropped out of school in Class 7 due to lack of school fees and, like her mother, has no stable source of income. The entire household depends on her elder brother, who does casual jobs to support them. In her free time, Sarah enjoys reading. Sarah was aware she was expecting her second child. She managed to attend two ANC clinics, each requiring her to walk about one and a half hours to and from the hospital. On the day of delivery, she began experiencing abdominal pains and went to the health facility, where she delivered normally. Shortly after giving birth, she developed heavy bleeding and noticed a rapidly enlarging vaginal swelling. She was urgently referred to Siaya County Referral Hospital for advanced care. By the time she arrived, she was extremely weak, dizzy, and unable to walk. She was taken straight to the emergency unit, where she was diagnosed with postpartum haemorrhage, severe anaemia, and a vulvovaginal haematoma. A vulvovaginal haematoma is a collection of blood that forms in the tissues of the vulva or vagina after childbirth. It happens when blood vessels are torn or injured during delivery, often due to difficult or prolonged labour or a large baby size. The condition is dangerous and life-threatening because the woman can lose a large amount of blood internally without obvious external bleeding. As the haematoma enlarges, the patient may develop severe pain, weakness, dizziness, and signs of shock due to blood loss. Sarah learned about Helpster Charity while admitted in the hospital. A few days into her stay, she began asking about her hospital bill and expressed concern that she would not be able to afford it, even requesting discharge since she was already feeling better. The social worker conducted an assessment and confirmed she was underprivileged. She was then reassured that Helpster Charity would cover her medical expenses and was encouraged to remain in the hospital to complete her treatment.

Sarah was brought as a referral after started to bleed after child birth and swollen vaginal hematomas. She was taken to surgery where the hematoma was evacuated after a longitudinal dissection. She was then admitted for post surgery monitoring. During which she was administered morphine, paracetamol, flagyl among other drugs . She responded well to medication and was eventually discharged on orals .

Sarah presented with serious obstetric complications following a normal delivery. Postpartum haemorrhage and vulvovaginal haematomas can be life-threatening if not treated promptly. Sarah’s prognosis is good, provided she completes her full course of treatment and receives proper follow-up care. With timely management, postpartum haemorrhage and vulvovaginal haematomas usually resolve without long-term complications. As her haemoglobin levels improve and the swelling reduces, she is expected to regain strength and return to her normal daily activities.