BACKGROUND: Fibrin sealant commonly is used topically for hemostasis in cardiovascular surgery. Complicated vulvar and vaginal bleeding after vaginal delivery can be difficult to manage using traditional techniques.
CASE: A 21-year-old primipara, after a spontaneous vaginal delivery of a twin gestation, was found to have expanding right labial swelling and ecchymosis extending from the superior part of the labia majora to the ischial fossa that was approximately 10 cm wide. Surgical exploration was pursued, but poor tissue quality limited the effectiveness of traditional hemostatic techniques. Prompt hemostasis was achieved with application of fibrin sealant.
CONCLUSION: Fibrin sealant may be useful for hemostasis when traditional techniques fail in complicated lacerations of the vulva and vagina associated with obstetric delivery.
Fibrin sealant can be used for complicated postpartum vaginal bleeding and tissue reapproximation.
From Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Departments of Obstetrics and Gynecology, Lebanon, New Hampshire.
See related editorial on page 401.
Corresponding author: James L. Whiteside, MD, Dartmouth-Hitchcock Medical Center, Department of Obstetrics and Gynecology, One Medical Center Drive, Lebanon, NH; e-mail: James.L.Whiteside@Hitchcock.org.
Financial Disclosure The authors did not report any potential conflicts of interest.