O'Brien Brooke, Smoleneic John
Obstetrics and Gynaecology Registrar, Liverpool Hospital, Sydney, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2013 Oct;53(5):451-4. doi: 10.1111/ajo.12127. Epub 2013 Aug 6.
Cervical varicosities (CVs) have been reported infrequently in pregnancy and have been associated with significant antepartum and postpartum haemorrhage. The most common association with CVs in pregnancy in the literature is placenta praevia.
To further investigate the association between placenta praevia and CVs.
A retrospective audit of all cases of placenta praevia that had an ultrasound in the Feto-Maternal Unit at Liverpool Hospital over the period January 2001 to January 2012. Patient outcomes were obtained from the hospital paper and electronic medical records, including mode of delivery and blood loss.
Eighty-four cases of placenta praevia were identified, and 78 had saved images that were reviewed. 51 of these 78 cases had transvaginal ultrasound (TVUS) images, which identified nine further cases of cervical varicosities. All cases of CVs were complicated by APH and delivered by caesarean section. There was no significant difference in the blood loss at delivery between the placenta praevia with CVs and those without (925 vs 870 mLs P = 0.3877).
Cervical varicosities are not as rare as the literature would suggest. The clinical relevance of the additional finding of CV on TVUS in cases of placenta praevia is questionable.
宫颈静脉曲张（CVs）在孕期的报道较少，且与产前及产后大出血有关。文献中孕期CVs最常见的关联是前置胎盘。
进一步研究前置胎盘与CVs之间的关联。
对2001年1月至2012年1月期间在利物浦医院母婴单元进行超声检查的所有前置胎盘病例进行回顾性审计。从医院纸质和电子病历中获取患者结局，包括分娩方式和失血量。
共识别出84例前置胎盘病例，其中78例保存了可供复查的图像。这78例中的51例有经阴道超声（TVUS）图像，从中又发现了9例宫颈静脉曲张病例。所有CVs病例均并发产前出血，并通过剖宫产分娩。有CVs的前置胎盘病例与无CVs的病例在分娩时的失血量无显著差异（925 vs 870 mL，P = 0.3877）。
宫颈静脉曲张并不像文献所显示的那么罕见。在前置胎盘病例中，TVUS额外发现CVs的临床意义值得怀疑。
