Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature

Piccioni, Maria Grazia; Derme, Martina; Salerno, Laura; Morrocchi, Elisa; Pecorini, Francesco; Porpora, Maria Grazia; Brunelli, Roberto

doi:10.1155/2019/5825309

Cited by 6 publications

(17 citation statements)

References 13 publications

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“…Within the scarce available literature on epistaxis in pregnant women, conservative treatments, such as intravenous tranexamic acid administration, nasal packing and bipolar cautery, are generally recommended as first-line measures. If conservative measures fail, surgical care under general anesthesia may need to be considered [13,14]. The question remains, however, whether these recommendations are generalizable to expectant mothers with HHT.…”

Section: Epistaxis During Pregnancy and Delivery In Hht Patientsmentioning

confidence: 99%

HHT-Related Epistaxis and Pregnancy—A Retrospective Survey and Recommendations for Management from an Otorhinolaryngology Perspective

Andorfer¹,

Seebauer²,

Dienemann³

et al. 2022

JCM

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Appropriate management of hereditary hemorrhagic telangiectasia (HHT) is of particular importance in females, as HHT-mediated modifications of the vascular bed and circulation are known to increase the risk of complications during pregnancy and delivery. This study was undertaken to evaluate female HHT patients’ awareness of and experience with HHT during pregnancy and delivery, with a focus on epistaxis. In this retrospective study, 46 females (median age: 60 years) with confirmed HHT completed a 17-item questionnaire assessing knowledge of HHT and its pregnancy-associated complications, the severity of epistaxis during past pregnancies and deliveries, and the desire for better education and counselling regarding HHT and pregnancy. Results revealed that 85% of participants were unaware of their disease status prior to the completion of all pregnancies. Further, 91% reported no knowledge of increased pregnancy-related risk due to HHT. In regard to epistaxis, 61% of respondents reported experiencing nosebleeds during pregnancy. Finally, approximately a third of respondents suggested that receiving counseling on the risks of HHT in pregnancy could have been helpful. Findings suggest that awareness of HHT and its potential for increasing pregnancy-related risk is poor. Best practices in HHT management should be followed to minimize negative effects of the disorder.

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Section: Epistaxis During Pregnancy and Delivery In Hht Patientsmentioning

confidence: 99%

HHT-Related Epistaxis and Pregnancy—A Retrospective Survey and Recommendations for Management from an Otorhinolaryngology Perspective

Andorfer¹,

Seebauer²,

Dienemann³

et al. 2022

JCM

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“…The nasal mucosa is influenced by systemic, local, metabolic or hormonal disorders that cause slowed mucociliary function during pregnancy. [1][2][3] The otolaryngological (ENT) symptoms encountered during pregnancy are most often mild, sometimes indicative of a specific pathology. 1,2 Pregnancy promotes a set of physiological changes in the female body, The ENT organs undergo the influence of its changes by certain manifestations within it such as rhinitis, epistaxis, and some disorders of the inner ear.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The otolaryngological (ENT) symptoms encountered during pregnancy are most often mild, sometimes indicative of a specific pathology. 1,2 Pregnancy promotes a set of physiological changes in the female body, The ENT organs undergo the influence of its changes by certain manifestations within it such as rhinitis, epistaxis, and some disorders of the inner ear. 1,2,4 Prevalence of epistaxis in non-pregnant female population is estimated at 6%, but this rate doubles in pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Severe epistaxis and pregnancy ''about two cases'' and review of the literature

Baba¹,

Dicko²,

Dicko

et al. 2022

Int J Otorhinolaryngol Head Neck Surg

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<p>Epistaxis is a health ENT problem which is still current, this is one of the commonly encountered emergencies in Rhinology. The nasal mucosa suffered influence systemic, local, metabolic or hormonal disorders causing a slowdown of muco-ciliary function during pregnancy. These observations relate the clinical and therapeutic particularities of the management for severe epistaxis in women during the last trimester of pregnancy. The woman's hormonal system is unique in its kind due to cyclic changes during pregnancy, the menstrual cycle and menopause. Our clinical observations confirm the effects of these metabolic, endocrinological and physiological alterations related to pregnancy. In a tropical environment with the inadequacy of ENT specialists, base medical personnel is often confronted with delicate clinical situations in the evolution of ENT diseases. Management for epistaxis during pregnancy is special because of its context, well evident diagnosis requires vital gestures as evidenced by our observations. The ear, nose and throat specialist must necessarily be well warned of its physiological changes during pregnancy to better understand the clinical evolution of certain common throat diseases as epistaxis. Epistaxis during pregnancy is a subject that remains topical in the field of care, it is promoted directly or indirectly by hormonal changes. Multidisciplinary management in coordination must be done in a timely manner because the risks are not negligible for the health of the mother and the child.</p>

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“…El Goulli et al in 1979 [1] reported on a case of severe epistaxis in pregnancy with maternal collapse and fetal death. From then on few case reports have been published) [1-9] (Table 1) with different management of epistaxis in third trimester of pregnancy. Furthermore, the mode of delivery, vaginally or by cesarean section, varies in this short report, probably due to qualitative and quantitative levels of blood loss.…”

Section: Introductionmentioning

confidence: 99%

“…Epistaxis is a common problem in pregnancy, secondary to an increased nasal mucosa vascularity. A large volume epistaxis is uncommon in women without risk factors (such as anticoagulants therapy or blood clotting disorders) [9]. When severe blood loss through the nose occurs in third trimester of pregnancy there are different therapeutical approaches: nose packing, hemostatic foam/sponge, cautery or diathermy, ligation of sphenopalatine artery.…”

Section: Introductionmentioning

confidence: 99%

The way a nose could affect pregnancy: severe and recurrent epistaxis

Giambanco¹,

Iannone²,

Borriello³

et al. 2019

Pan Afr Med J

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Massive and severe epistaxis is an uncommon event in pregnancy. It could be life threatening and could affect the normal pregnancy course. The best management is still on debate; it could be medical, conservative or surgical. Pregnancy termination often is problem solving. Hormonal changes during pregnancy affects nasal physiology. Vaginal delivery, labour induction or cesarean section are all suitable, after hemodynamic stabilization of pregnant woman. We report a case and review the available literature.

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Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature

Cited by 6 publications

References 13 publications

HHT-Related Epistaxis and Pregnancy—A Retrospective Survey and Recommendations for Management from an Otorhinolaryngology Perspective

HHT-Related Epistaxis and Pregnancy—A Retrospective Survey and Recommendations for Management from an Otorhinolaryngology Perspective

Severe epistaxis and pregnancy ''about two cases'' and review of the literature

The way a nose could affect pregnancy: severe and recurrent epistaxis

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