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Explosion of a vulvar hematoma during spontaneous vaginal delivery. A case report
S D Joy1, J F Huddleston, R McCarthy
1Department of Obstetrics and Gynecology, University of Florida Health Science Center, 653-1 West 8th Street, Jacksonville, FL 32209, USA.
Background:
Vulvar hematoma formation during a spontaneous vaginal birth is rare. Although conservative management or observation is an option, complications, including delivery obstruction and excessive vaginal bleeding, may occur.
Case:
A woman presented in active labor with an enlarging vulvar hematoma reaching the size of a softball. Spontaneous vaginal delivery occurred with an "explosion" of the hematoma and excessive blood loss. To obtain hemostasis, the hematoma cavity was explored and the bleeding points sutured.
Conclusion:
With a large intrapartum vulvar hematoma, the risk of rupture exists. If it occurs, delivery should be accomplished expediently, hemostasis achieved rapidly and blood loss monitored closely.