A rare case of life-threatening epistaxis in late pregnancy

Epistaxis is a common presentation to emergency departments. In cases of severe bleeding in the context of pregnancy cases can become very difficult to manage and normal haemostatic interventions may not prove as effective compared to non-pregnant patients. This cases describes a 36 year old female presenting with significant epistaxis refractory to several haemostatic measures including floseal (a biodegradable matrix sealant composed of gelatin granules and human thrombin) nasal packing, as well as both surgical and radiological interventions. Bleeding was never fully controlled with such measures for prolonged periods and delivery of the baby via C-section was the only method that halted the patient's haemorrhage. This challenging case highlighted the necessity of employing a stepwise approach to managing epistaxis in the context of pregnancy. Furthermore, it emphasizes the need for early consultation with obstetric colleagues and the overall advantages of acquiring multi-disciplinary input for these unique cases.