Although epistaxis is a common problem during pregnancy, severe epistaxis necessitating surgical management is rare. Herein, we report 2 cases of severe epistaxis in the absence of any underlying risk factors for hemorrhage during pregnancy.
The first case, a 41-year-old female in the 12th week of pregnancy presented with severe epistaxis of sudden onset. As conventional management failed to control the epistaxis, we performed electrocauterization of the mucosa lining the nasal septum and sphenopalatine foramen under local anesthesia. The epistaxis was successfully controlled by this procedure, and her subsequent pregnancy and delivery were uneventful.
The second case, a 36-year-old woman who was 24 weeks pregnant presented with profuse epistaxis. The epistaxis was not controlled by the insertion of a gauze packing into the nasal cavity and posterior packing with a balloon catheter. Therefore, we performed electrocauterization of the area supplied by the sphenopalatine artery and anterior ethmoidal artery under general anesthesia. The epistaxis was successfully controlled by this surgery, and the woman went on to deliver a healthy baby.
The management options for severe epistaxis should be carefully selected during pregnancy. Early involvement of gynecologists and anesthesiologists is crucial in these cases. We report the management of these cases and present a review of the literature on severe epistaxis during pregnancy.
