Title: Postpartum Vulvar Hematoma A Case Report
Authors: A.OURIAGHLI, M.ZEMMARI, A.EL ABBASSI, J.KOUACH, M.A.BABA HABIB
Volume: 9
Issue: 10
Pages: 52-54
Publication Date: 2025/10/28
Abstract:
Background: Vulvar hematoma is an uncommon postpartum complication that may lead to significant blood loss, severe pain, urinary retention, and even hemodynamic instability. Case presentation: We present a case of a 27-year-old primigravida who developed a rapidly expanding posterior vulvar hematoma approximately one hour after an otherwise uncomplicated spontaneous vaginal delivery with a second-degree perineal tear. Clinical assessment revealed a tense, tender 7 × 5 cm swelling of the posterior commisure of the labias majus, hypotension, tachycardia, and a drop in hemoglobin from 11.2 g/dL to 9.5 g/dL. Following resuscitation with crystalloid fluids and transfusion of two units of packed red blood cells, prompt surgical exploration under spinal anesthesia was performed. Approximately 200 mL of clot was evacuated and two bleeding branches of the pudendal artery were ligated. Dead-space obliteration, layered closure and temporary vaginal packing were performed. The postoperative course was uneventful and the patient was discharged on day 4. Conclusions: Rapid recognition and timely surgical management are critical in large or expanding postpartum vulvar hematomas to prevent ongoing hemorrhage, tissue necrosis and infection. A high index of suspicion during the immediate postpartum period and clear escalation protocols for resuscitation and surgical intervention can markedly improve maternal outcomes.