Cervical varices complicated by thrombosis in pregnancy

Abstract

We present a case of a 36-year-old

Cervical varices: An unusual source of first‐trimester hemorrhage

“…Our literature review identified eight other cases of cervical varices causing significant obstetrical hemorrhage (Table ). Although recognizing that limited conclusions may be drawn from these reports, it appears that varices are commonly associated with low placental implantations, maternal age ≥35, multiple gestations, and in vitro fertilization . A review of two other manuscripts cited as additional cases of varices in diethylstilbestrol‐exposed women suggests that these findings represent a different entity.…”

“…Delivery planning should anticipate and prepare for possible massive transfusion and hysterectomy . Varices reportedly resolve within 3 days to 6 weeks following delivery . Absent any reports, recurrences and risks with future pregnancies remain unknown.…”

“…Although recognizing that limited conclusions may be drawn from these reports, it appears that varices are commonly associated with low placental implantations, maternal age 35, multiple gestations, and in vitro fertilization. [1][2][3][4][5][6][7] A review of two other manuscripts cited as additional cases of varices in diethylstilbestrol-exposed women suggests that these findings represent a different entity. Therefore, these cases are not included in the table.…”

“…Endocervical varices seem to be associated with clinically significant bleeding earlier in pregnancy than subserosal or stromal varices. 1,3,5,6 Management, including delivery timing of affected pregnancies, should be individualized based on the patient's hemodynamic status, clinical course, gestational age, and wishes regarding the pregnancy. It seems reasonable to avoid Valsalva maneuver, coitus, and digital pelvic exams.…”

“…4,6,7,10 Varices reportedly resolve within 3 days to 6 weeks following delivery. [1][2][3][4][5][6][7]10 Absent any reports, recurrences and risks with future pregnancies remain unknown.…”