Introduction: Isolated massive vulval oedema in pregnancy is rare. In the postpartum period, it has been associated with maternal mortality.

Methodology: We report a case of a massive bilateral vulva oedema that developed in labour and persisted post delivery. 

Results: A 33-year old primigravida presented in spontaneous labour and developed massive bilateral vulval swelling intra partum. She had a vaginal delivery without instrumentation. Post partum examination revealed a huge vulval swelling bilaterally with bluish discolouration only on the lower parts of the labia minora. A contrasted computed tomography of the pelvis reported a huge perineal haematoma. An examination under anaesthesia revealed only a small haematoma with mainly oedematous surrounding tissue. A spontaneous and complete resolution of the vulval oedema was observed 4 weeks later.       

Conclusion: This case highlights the dilemmas faced by obstetricians in the diagnosis and management of massive postpartum vulval oedema. Literature related to the differential diagnosis and clinical outcomes of postpartum vulval oedema are discussed to guide future management.  

Keywords: Massive vulval oedema, post partum period