Saedi Nafisseh, Ghaemi Marjan, Moghadam Mona, Haddadi Mohammad, Hashemi Zeinab, Hantoushzadeh Sedigheh
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Int J Surg Case Rep. 2023 Jul;108:108425. doi: 10.1016/j.ijscr.2023.108425. Epub 2023 Jun 17.
Vaginal bleeding might accrue during pregnancy and it has different causes due to the pregnancy trimester and the diagnosis and management would be crucial to prevent maternal-fetal life-threatening situations. In uncommon cases, varicose veins can emerge in the neck of the uterus, leading to a severe maternal hemorrhage.
We presented a pregnant woman with vaginal bleeding and spotting during pregnancy with the diagnosis of cervical varix at 22 weeks of gestation. Close monitoring and proper patient education led to a term delivery at 37 weeks of gestation. Otherwise, an emergency postpartum hysterectomy after a cesarean section was performed due to uncontrolled bleeding from cervical varix.
Although rare, cervical varix should be included in the differential diagnosis in a pregnant patient who appears with extensive vaginal bleeding to reduce maternal and/or neonatal morbidity or fatality. The approved diagnosis for that is not clear.
This case report showed that Doppler and transvaginal sonography could be suitable diagnostic tools. The best management for cervical varix needs further research.
孕期可能出现阴道出血，由于孕期不同阶段其原因各异，诊断和处理对于预防危及母婴生命的情况至关重要。在罕见情况下，子宫颈可出现静脉曲张，导致严重的母体出血。
我们报告了一名孕妇，在妊娠22周时出现阴道出血和点滴出血，诊断为宫颈静脉曲张。密切监测和适当的患者教育使患者在妊娠37周时足月分娩。否则，因宫颈静脉曲张出血无法控制，剖宫产术后进行了紧急产后子宫切除术。
尽管罕见，但对于出现大量阴道出血的孕妇，鉴别诊断应包括宫颈静脉曲张，以降低母体和/或新生儿的发病率或死亡率。对此的确诊尚不明确。
本病例报告表明，多普勒和经阴道超声检查可能是合适的诊断工具。宫颈静脉曲张的最佳治疗方法需要进一步研究。
