Introduction:

• Perineal abscess is a rare but serious complication following instrumental delivery.

• Requires prompt recognition and multidisciplinary management to prevent morbidity. 

• This case highlights the challenges in managing a perineal abscess after a forceps delivery, emphasizing theimportance of early intervention and teamwork.

• A 26 -year-old primigravida with gestational diabetes and a large-for-gestational-age fetus.

• Induced at 38 weeks of gestation. A forceps-assisted vaginal delivery after manual rotation of the fetal head, after aprolonged 2nd stage of labour.

•  Within 24 hours of delivery, she returned to the operating theatre for evacuation of a vulval hematoma and repair of anidentified third-degree perineal tear (3A).

• Day 5 Postnatally, she developed severe excruciating perineal pain and skin colour changes, a likely perineal abscess.

• A multidisciplinary team (MDT) consisting of obstetrics, gynaecology, and plastic surgery specialists was initiated tomanage the case, ensuring optimal wound care and recovery, which required daily surgical debridements.