Severe Vulvovaginal Varicosities in Pregnancy

Pratilas, Georgios Chrysostomos; Dinas, Konstantinos

doi:10.1056/nejmicm1715053

Cited by 7 publications

(6 citation statements)

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“…In our literature review, 11 cases of VVs in pregnancy were identified at the final analysis, including the present case ( Table 1 ). 2 – 7 , 11 – 14 The median age was 29 years. All of the women were pregnant at full term.…”

Section: Discussionmentioning

confidence: 99%

“…VVs usually disappear within approximately 30 to 40 days after delivery. 2 The occurrence of severe VVs is a rare event in pregnant women. In these cases, the decision-making process is more demanding regarding the timing and the mode of delivery.…”

Section: Introductionmentioning

confidence: 99%

“…Several cases in the literature showed cesarean section (CS) as the delivery mode of choice in these extreme clinical conditions. [2][3][4][5][6][7] A further crucial variable in VVs is represented by the setting where the birth occurs. CS rates are frequently higher in spoke maternity units than in hub hospitals because of unsuitable settings for prompt action with severe obstetric complications.…”

Section: Introductionmentioning

confidence: 99%

“…Several cases in the literature showed cesarean section (CS) as the delivery mode of choice in these extreme clinical conditions. 2 – 7 …”

Section: Introductionmentioning

confidence: 99%

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Huge vulvar varicosities in pregnancy: case report and systematic review

et al. 2022

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The appearance of severe vulvovaginal varicosities (VVs) is challenging in pregnancy. The management of VVs may require a multidisciplinary approach, including radiologists, vascular surgeons, and obstetricians. We report a rare case of enormous VVs and pubic varicosities and summarize similar cases in the literature. A woman in her 20s with a full-term pregnancy visited our hospital for severe VVs and pubic varicosities. She had been in a spoke maternity unit where a cesarean section was scheduled. After a multidisciplinary evaluation, we offered her the chance to have a vaginal delivery (VD). The woman had an uneventful VD, and VVs disappeared after 40 days. A comprehensive literature search on this topic showed 11 cases of VVs during pregnancy (five VDs and six cesarean sections). The presence of VVs represented the indication for surgery in 70% of cases. Severe complications occurred in 20% of VDs vs. 50% of CSs. In pregnant women with VVs, the risk-benefit ratio suggests a chance of having VD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Several cases in the literature showed cesarean section (CS) as the delivery mode of choice in these extreme clinical conditions. 2 – 7 …”

Section: Introductionmentioning

confidence: 99%

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Huge vulvar varicosities in pregnancy: case report and systematic review

et al. 2022

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“…Much of the literature focuses on vulvar varicosities during pregnancy because vaginal venous flow occurs via a venous plexus that communicates with numerous plexuses, such as the vesical and haemorrhoidal plexuses [19]. Furthermore, vulvovaginal varicosities are aggravated by delivery, as described by Pratilas and colleagues [20]. In that case, the 34-year-old patient carried one male foetus delivered via C-section, and the vaginal varicosities were found during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

An unusual cause of postmenopausal vaginal haemorrhage: a case report

Sun

Guo

et al. 2019

BMC Women's Health

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BackgroundPost-menopause vaginal haemorrhage is typically related to gynaecological malignancies. Bleeding from vaginal varices rarely occurs, especially in nonpregnant women. Moreover, nonpregnancy-related causes of vaginal varicosities include portal hypertension, especially that caused by liver cirrhosis, pelvic congestion syndrome and Klippel-Trenaunay syndrome or Parkes-Weber syndrome. Here, we report an unusual cause of nonpregnancy-associated vaginal variceal bleeding.Case presentationA 55-year-old postmenopausal woman presented in our outpatient department with complaints of recurrent bloody vaginal discharge. A group of varicose veins and several haemorrhagic spots were found on her vaginal wall during a vaginal speculum examination. Genital cancers were excluded by colposcopy and transvaginal ultrasonography; furthermore, a pelvic arteriovenous fistula was not found on a pelvic computed tomography (CT) scan. However, congenital varicosities and deep arteriovenous shunts were observed in her left leg on arterial angiography. Moreover, vaginal bleeding was improved after resolution of the underlying deep arteriovenous shunts in her left leg. Therefore, congenital arteriovenous shunts and elevated inferior vena cava pressure might be responsible for her recurrent vaginal varicose bleeding.ConclusionHaemorrhage due to vaginal varices is easily detected with a vaginal speculum examination. However, diagnosis and treatment of the original disease are important after bleeding is controlled.

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Medizin¹

2018

InFo Neurologie

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Severe Vulvovaginal Varicosities in Pregnancy

Cited by 7 publications

References 0 publications

Huge vulvar varicosities in pregnancy: case report and systematic review

Huge vulvar varicosities in pregnancy: case report and systematic review

An unusual cause of postmenopausal vaginal haemorrhage: a case report

Niedrig dosiertes Hydrokortison ohne Vorteile

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