Peripartum Perineal Injuries – Prospective Analyis At A Tertiary Referral Centre

Abstract Background: Postpartum vulval haematoma is a rare but serious complication following vaginal delivery. It can lead to significant morbidity and, if left untreated, may result in life-threatening conditions. The identification of risk factors and the assessment of maternal outcomes are crucial for improving management and preventing adverse consequences. The aim of this study was to assess the risk factors, clinical presentation, management strategies, and maternal outcomes of postpartum vulval haematomas in a tertiary care center in Uttar Pradesh over a one-year period. Material and Methods: This was a prospective study conducted for 1 year (from January 2024 to December 2024) at SNMC Agra, a tertiary care center in Uttar Pradesh. Out of total vaginal deliveries, 54 women were diagnosed with vulval haematoma following delivery were included in the study. Patient data including demographic details, obstetric history, clinical features, management protocols, and maternal outcomes were reviewed. Risk factors such as parity, place of delivery (home/institutional), instrumental delivery, prolonged labor, and perineal trauma and previous surgery over perineal or episiotomy were analyzed. Results: The study found that the majority of patients presenting with vulval haematomas were primiparous (81.48%). Almost 18.52% of them had institutional delivery. The most common presenting symptoms was pain in all cases and bleeding in 96.30% of cases. There were no cases of maternal mortality. Conclusion: Postpartum vulval haematoma, though rare, can result in significant maternal morbidity if not promptly managed. Early recognition and intervention, including both surgical and conservative options, contribute to positive outcomes. The identified risk factors highlight the importance of vigilant monitoring during and after delivery, particularly for women with primiparous, preeclampsia and those undergoing instrumental deliveries.