A case report of massive vulvar edema during tocolysis of preterm labor

Article Abstract:

Vulvar edema is the accumulation of fluid in the tissues of the vulva, the external portion of the vagina. It may result from injury, infection, or the blockage of the lymphatic or blood vessels. Vulvar edema may also be associated with conditions that cause edema in the feet, such as heart, kidney, and liver failure or cancer; complications of pregnancy, such as preeclampsia or prolonged labor; or the use of a birthing chair, in which body position and resulting pressure may contribute to swelling. A case is described of a pregnant 20-year-old woman who developed vulvar edema during tocolysis, the inhibition of uterine contractions. The patient went into premature labor at 34 weeks of pregnancy and was given the drugs ritodrine and magnesium sulfate intravenously to prevent uterine contractions. Vulvar edema developed on the right side of the vulva five days after starting drug therapy, and spread to the left side of the vulva within the following 24 hours. The patient did not develop a fever, maintained a normal blood pressure, and had no evidence of infection or general edema. The vulvar edema did not improve after treatment with antibiotics or care of the affected skin. The edema had blocked off the opening of the vagina, preventing examination, nine days after admission to the hospital. A cesarean section was performed and a live female infant was delivered. The patient recovered without complications and the vulvar edema resolved within four days. In this case, the vulvar edema was thought to result from the prolonged use of tocolytic agents, which caused fluid retention. In addition, the position of the patient during prolonged bed rest most likely contributed to the fluid accumulation at the vulva. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Vulva, Edema

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Intercourse-related vaginal pain syndrome: a variant of "vulvar vestibulitis syndrome?"

Article Abstract:

Intercourse-related vaginal pain syndrome appears to be distinct from vulvar vestibulitis syndrome. Vulvar vestibulitis syndrome is characterized by reddened, inflamed, very painful areas in the vestibular glands of the vulva. A 23-year-old woman first experienced severe vaginal pain during her first episode of intercourse. The pain recurred with each episode of intercourse and eventually made using tampons painful. The pain would last for two to three hours after intercourse. Previous pelvic exams found no physical abnormalities and tests for infectious organisms were negative. However, muscle spasms and pain were initiated by palpation around the vaginal introitus. The patient's grandmother and great-grandmother had similar symptoms that only disappeared after the vaginal delivery of their first children.

Fibromyalgia, Dyspareunia

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Pulmonary edema in obstetric patients is rapidly resolved except in the presence of infection or of nitroglycerin tocolysis after open fetal surgery

Article Abstract:

Pregnancy complications

Care and treatment, Fetus, Surgery, Pulmonary edema, Fetal surgery

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