Idiopathic massive vulvar edema in late pregnancy: a rare case report

Abstract

Massive vulvar edema during pregnancy is a rare clinical condition usually associated with preeclampsia, severe anaemia, infection, trauma, or systemic disorders. Idiopathic vulvar edema without any identifiable cause is uncommon and poorly documented in the literature. We report a rare case of idiopathic massive vulvar edema occurring during late pregnancy. A 22-year-old gravida 2 para 1 live 1 woman presented at 33 weeks and 4 days of gestation with progressively increasing vulvar swelling for six months. Clinical examination revealed massive bilateral vulvar edema involving both labia majora and minora. Laboratory investigations, including urine protein, renal and liver function tests, and urine culture, were within normal limits. Systemic and local causes of vulvar edema were excluded. The patient was managed conservatively with bed rest, pelvic elevation, local ice packs, and supportive medications. Significant reduction in edema was observed within two days, with near complete resolution after five days of conservative management. At 35 weeks of gestation, the patient presented again with spontaneous preterm labor and recurrent vulvar edema. She subsequently delivered vaginally a healthy 2.4 kg male neonate with good Apgar scores. Complete spontaneous resolution of vulvar edema occurred during the early puerperium. Idiopathic massive vulvar edema in pregnancy is a rare but generally benign condition. Careful evaluation is necessary to exclude secondary causes. Most cases can be managed successfully with conservative treatment, and spontaneous postpartum resolution is commonly observed.