Uncommon Sequela of Miscarriage: A Case of Hematometra

Hematometra is an uncommon and delayed complication following the surgical management of miscarriage. When it occurs in the early postoperative period, it is sometimes referred to as "Redo syndrome". We present the case of a 39-year-old woman who developed this rare condition following a suction and evacuation procedure performed for a missed miscarriage. Within 48 hours of the procedure, the patient presented with acute lower abdominal pain, low-grade fever, dysuria, and pain during defecation. Despite her symptoms, her vital signs remained stable. However, laboratory investigations revealed an elevated C-reactive protein (CRP) level, indicating inflammation. She was started on broad-spectrum antibiotics. A transvaginal ultrasound revealed the presence of hematometra, a collection of blood within the uterine cavity. The patient underwent a repeat uterine evacuation under ultrasound guidance, during which approximately 50 mL of dark blood clots were removed. She recovered well post-procedure and was discharged the following day in a stable condition. Follow-up scan done after two weeks was normal. This case highlights the importance of considering hematometra, or Redo Syndrome, in patients presenting with abdominal pain and systemic symptoms shortly after surgical miscarriage management. Early recognition and prompt intervention are essential to prevent further complications and to ensure patient recovery.