Background
Genital trauma is common in gynaecologic practice and causes tend to differ depending on the age of the patient. Although Vulva haematoma is more common in Obstetrics with an incidence of 1-2 per 1000 deliveries, there are a rare occurrence in Gynaecology with incidence of 3.7%, and constitute 0.8% of all gynaecological emergencies. We present a rare case of post-coital vulva haematoma with acute urinary retention in pregnancy that was successfully surgically managed with subsequent positive pregnancy outcome.

Methods
We present a case of a 19year old, NA. She was a black African Ugandan, primigravida at 21 weeks of amenorrhoea. She presented with a 16hours history of post-coital painful genital swelling and acute failure to pass urine.

On examination, abdominal findings revealed a symphysis-fundal height corresponding to 22 weeks of amenorrhoea, distended urinary bladder and a tender cystic left vulvar swelling extending to involve the labia minora on the right.

Management: Involved surgical evacuation of the haematoma with insertion of the catheter drain. She healed well and had Cul de sac catheter drain removed on day 6 and urethral catheter removed on day 8. She was enrolled into antenatal care.

Conclusions
Gynaecology emergency attendees must be suspicious of the rare causes of vulvar haematomas such as coitus and exclude them from common ones such as Bartholin’s abscess and cysts, vulva varicosities and folliculitis.