Dean A. Seehusen, MD, MPH; J. Scott Earwood, MD


J Am Board Fam Med. 2007;20(4):408-410. 

In This Article

Literature Review

Labial adhesions in the postpartum setting are rare. A Medline literature review using the terms "labial adhesions" in combination with "postpartum" or "postnatal" was conducted. Relevant articles' references were reviewed for other possibly important literature. This search revealed only 9 previously reported cases of labial adhesions after vaginal delivery. Table 1 summarizes these cases.

Difficulty resuming sexual activity was the most commonly reported complaint.[4,5,8,9,10,11] All but one of the previously reported cases of postpartum labial adhesions reported disruption of the vaginal mucosa. This ranged from "skid marks" to third-degree perineal laceration. The remaining case did not specifically mention presence or absence of perineal trauma during delivery. In several of the cases, including the current case, superficial lacerations were left unrepaired. Superficial labial lacerations are often left unrepaired with good outcomes. Even larger vaginal wall lacerations will generally heal with similar outcomes if left unsutured as reported in some of the Midwifery literature.[5] Lin et al theorized that significant perineal swelling may promote adhesion formation by mechanically pressing the labia together.[3]


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