Antepartum vulva haematoma, surgical intervention and subsequent vaginal delivery.
Orisabinone IB1, Oweisi PW1, Oriji PC1*, Wagio TJ1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Oriji, Peter Chibuzor; +234 706 423 3209; chibuzor54@gmail.com
Abstract
Background: The vulva is not a common site of injuries due to its location and the protective effects of the spontaneous adduction of the thighs which prevents direct trauma to the vulva. Obstetric vulva haematomas are usually seen following delivery as a result of soft tissue injuries or iatrogenic injuries from episiotomies.
Case Presentation: A 27-year-old unbooked G5 P4+0 (4 living children) at 32 weeks’ gestational age who presented to the emergency unit with complaints of vulva pain and mild bleeding following a road traffic accident in which she sat astride on a motor bike. She had examination under anaesthesia, haematoma evacuation and application of haemostatic stitches. She was placed on analgesics, antibiotics, tocolytics and haematinics. Vulva swelling resolved and she was discharged after 48 hours on admission in good health condition.
Conclusion: Vulvar haematomas, although not very common may occur during and outside pregnancy from a variety of causes like blunt trauma as in the case discussed. Occasionally these haematomas may be potentially life-threatening and may require urgent surgical intervention for haematoma evacuation and to secure haemostasis.
Keywords: Vulva haematoma, Road traffic accident, Life-threatening, Haematoma evacuation, Haemostatic stitches.
Cite this article: Orisabinone IB, Oweisi PW, Oriji PC, Wagio TJ. Antepartum vulva haematoma, surgical intervention and subsequent vaginal delivery. Yen Med J. 2020;2(1):179-182.
REFERENCES
- Saleem Z, Rydhström H. Vaginal haematoma during parturition: a population-based study. Acta Obstet Gynecol Scand. 2004;83(6):560–562.
- Morgans D, Chan N, Clark CA. Vulval Perineal Haematomas in the Immediate Postpartum Period and their Management. Aust N Z J Obstet Gynaecol. 1999;39(2):223–226.
- Ekweani JC, Oguntayo AO, Kolawale AOD, Zayyan MS. Vulva haematoma following straddle injury in pregnancy. Trop J Obstet Gynaecol. 2016;33(1):120–123.
- Geist RF. Sexually related trauma (review). Emerg Med Clin North Am. 1988;6:439–466.
- Vermesh M, Deppe G, Zbella E. Non- puerperal Traumatic Vulvar Hematoma. Z Geburtshilfe Perinatol. 1994;198:77–79.
- Ernest A, Knapp G. Severe traumatic vulva haematoma in a teenage girl. Clinical case reports. 2015;3(12):975–978.
- Propst AM, Thorp JM Jr. Traumatic vulvar hematomas: conservative versus surgical management. South Med J. 1998;91:144–146.
- Benrubi G, Neuman C, Nuss RC, Thompson RJ. Vulvar and vaginal hematomas: a retrospective study of conservative versus operative management. South Med J. 1987;80(8):991-994.
- Palacios JJM, García MR, Barbosa NE, Ferle L, Iriarte H, Conesa HA. Lower uterine blood supply: extrauterine anastomotic system and its application in surgical devascularization techniques. Acta Obstet Gynecol Scand. 2007;86(2):228-234.
- Nelson EL, Parker AN, Dudley DJ. Spontaneous vulvar hematoma during pregnancy: a case report. J Reprod Med. 2012;57(1-2):74-76.