Cervical varix with placenta previa totalis

Area of Science:

• Obstetrics and Gynecology
• Vascular Malformations
• Maternal-Fetal Medicine

Background:

• Cervical varices during pregnancy are exceptionally rare and pose significant risks, including hemorrhage and maternal morbidity.
• Established management protocols for cervical varices complicating pregnancy are lacking.
• This case involves a pregnant patient with co-existing placenta previa totalis and a cervical varix.

Observation:

• A 30-year-old woman presented with placenta previa totalis and an asymptomatic cervical varix.
• At 32 weeks' gestation, massive hemorrhage originated from the cervical varix.
• Bleeding was initially controlled with a vaginal pack, followed by a cesarean section due to uncontrollable uterine contractions.

Findings:

• Delivery of a 1655 g female infant was achieved.
• Estimated blood loss was significant at 1814 mL.
• The cervical varix markedly reduced in size post-delivery.

Implications:

• This case demonstrates a successful management strategy for a rare and potentially life-threatening obstetric emergency.
• The successful outcome underscores the importance of prompt intervention and multidisciplinary care.
• Further research into the management of cervical varices in pregnancy is warranted.