Clinical meaning
A vaginal or vulvar hematoma is a collection of blood within the soft tissues of the perineum, vagina, or vulva that develops when blood vessels are damaged during vaginal delivery. The blood accumulates in the loose connective tissue, producing visible or palpable swelling, severe pain disproportionate to the apparent injury, and discoloration. Hematomas may form even without visible lacerations when deeper vessels rupture beneath intact skin or mucosa. Predisposing factors include instrumental delivery (forceps or vacuum), episiotomy, prolonged second stage of labor, precipitous delivery, first vaginal delivery, and pre-existing coagulopathy. The nursing role focuses on vigilant postpartum monitoring, early recognition, comfort measures, and prompt reporting of findings to the healthcare team.