Vulvar and vaginal hematomas: a retrospective study of conservative versus operative management

We reviewed 32 cases of vulvar and vaginal hematomas treated at three hospitals in Jacksonville, Florida, from March 1975 to March 1985. Patients ranged in age from 14 to 37 years. In 29 patients the hematomas resulted from obstetric trauma and in three from other causes. We found that patients managed conservatively had more subsequent operative intervention and more complications requiring antibiotics and transfusion, and they required more days of hospitalization than patients managed operatively. We also found an increased risk of complications and increased hospitalization for patients with conservatively managed hematomas when the product of the longitudinal diameter and the transverse diameter was 15 or greater.