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What is A low risk primigravida underwent vaginal delivery with episiotomy. 2 hours after delivery patient appears pale, PR 110/min BP is 90/60 but there is no apparent PPH. PV examination shows a bulge over episiotomy stitch line. Hb shows a drop in Hb from 9 gm% to 7 gm%. Management is? and explain in detail?
The patient is showing signs of hemodynamic compromise with a significant drop in hemoglobin. This is suggestive of acute haemorrhage. As uterine bleeding is not evident and a bulge is present at site of episiotomy, it appears to be a case of a large hematoma at episiotomy which should be urgently explored, evacuated and bleeder should besecured.