One of the Obstetrical Emergencies, Puerperal Vulvar Hematoma Threatening Maternal Life

Abstract

Puerperal vulvar hematoma, causing serious morbidity and rarely mortality, is one of the life threatening obstetrical emergencies. A thirty year-old, gravida 7, parity 7, Turkish female patient was hospitalized from emergency department with the complaints of vulvar hematoma and postpartum bleeding after vaginal delivery at home. Genital examination revealed a fluctuating hematoma 8x4 cm on the left vulva. Hemoglobin level was 8.6 g/dL, hematocrit was 28%. Since moderate amount free fluid was determined on pelvic sonographic examination, the patient was operated with the suspect of uterine rupture. However, uterine rupture or retroperitoneal hematoma were not present. After the giant hematoma on vulva was evacuated, hemostasis was achieved and the operation was finished, leaving a hemovac drain. In the postoperative period, the patient was managed with intravenous antibiotic, blood transfusion, anti-inflammatory treatment and ice package on vulva, and was discharged from hospital on postoperative sixth day. We aimed to present the patient with puerperal vulvar hematoma which developed after vaginal home delivery and the management in our clinic, with a literature review.