In the recovery room, 1 hour after an outlet forceps delivery, a patient is found to have an 8 x 5 cm expanding, bluish & tense, painful right labia majora. The most appropriate management of this patient includes:
The above given history is suggestive of vulvar hematoma. Most cases can be managed conservatively, at least initially, but if the pain does not disappear and if there is suspicion of an expanding hematoma, it will be necessary to examine the areas with the patient under anesthesia and drainage in order to reduce the pain, accelerate the recovery and prevent secondary infection and necrosis
Vaginal packing
Vaginal exploration under GA
Exploratory laparotomy and Internal Illiac aery Ligation
Observation, Cold compress.
Obstetrics