title: A case report of massive vulvar edema during tocolysis of preterm labor.
abstract: Bilateral vulvar edema that is not associated with preeclampsia has been reported only rarely during pregnancy or the puerperium. A primiparous patient in premature labor at 34 weeks' gestation with no history of lymphatic or venous obstruction underwent combination tocolysis with intravenous ritodrine and magnesium sulfate. On the fifth day of tocolysis, edema developed in the right labium majus pudendi and gradually spread to the left labia during the ensuing 24 hours. The patient remained afebrile, normotensive, and without signs of localized infection or anasarca. A trial of triple intravenous antibiotics and local skin care proved ineffective. By the ninth hospital day, the edema and discomfort had progressed, thereby precluding vaginal examination without sedation. In spite of progressive cervical dilatation with tocolysis, cesarean delivery was performed. With no further treatment, the vulvar edema gradually resolved during the next week.
authors.affiliation: Department of Obstetrics and Gynecology, William Beaumont Army Medical Center, El Paso, TX 79920-5001.
authors.forename: C
authors.initials: C
authors.lastname: Brittain
authors.forename: J W
authors.initials: JW
authors.lastname: Carlson
authors.forename: D L
authors.initials: DL
authors.lastname: Gehlbach
authors.forename: A W
authors.initials: AW
authors.lastname: Robertson
mesh_terms: D000328:Adult; D002981:Clindamycin / Q000627:therapeutic use; D004487:Edema / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008278:Magnesium Sulfate / Q000009:adverse effects; D009254:Nafcillin / Q000627:therapeutic use; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D015145:Tocolysis / Q000009:adverse effects*; D014845:Vulvar Diseases / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D005839:Gentamicins; D002981:Clindamycin; D009254:Nafcillin; D008278:Magnesium Sulfate