title: Explosion of a vulvar hematoma during spontaneous vaginal delivery. A case report.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Florida Health Science Center, 653-1 West 8th Street, Jacksonville, FL 32209, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Joy
authors.forename: J F
authors.initials: JF
authors.lastname: Huddleston
authors.forename: R
authors.initials: R
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D005260:Female; D006406:Hematoma / Q000601:surgery*; D006470:Hemorrhage / Q000601:surgery; D006488:Hemostasis, Surgical; D006801:Humans; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000601:surgery*; D011247:Pregnancy; D012422:Rupture, Spontaneous; D014845:Vulvar Diseases / Q000601:surgery*