Large Vulva Haematoma Following Spontaneous Vaginal Delivery: Successful Conservative Management in Enugu, South East Nigeria

Abstract

Background: Vulva haematoma is an uncommon complication of childbirth that can cause maternal death if not properly managed. We present a case of large vulva haematoma managed conservatively with good outcome in UNTH Enugu. Clinical Presentation: This was a case of an unbooked 24 years old primiparous woman referred from a private hospital to UNTH, Enugu on account of left-sided vulva swelling of four hours duration following a spontaneous vaginal delivery of a live male baby that weighed 3.6 kilogrammes. She was given episiotomy which was repaired. Vaginal examination showed a swelling involving left labia majora and minora and extending to the perineal region and vagina. It measured 12 cm × 10 cm, firm and mildly tender. She was resuscitated with intravenous fluid, transfused with two units of blood and commenced on antibiotic and analgesic. The vulva haematoma was monitored and it remained the same size for two days, and then progressively regressed. She was discharged home on the 9th day. Conclusion: Conservative management of large vulva haematoma involving good counseling, correction of anaemia, institution of antibiotics, analgesic and close monitoring leads to effective resolution, reduced cost, scarring, pain and dyspareunia.