Uterine cervical varix with pregnancy complicated by suture at 17 weeks of gestation and continuation of pregnancy until 36 weeks of gestation

Abstract

Uterine cervical varices are rare complications of pregnancy that can cause massive bleeding when ruptured. However, there is a lack of sufficient research on its management strategies. We herein present a case of hemorrhage from cervical varix in which the bleeding site was sutured at 17 weeks of gestation and the pregnancy continued until 36 weeks. The patient was a 31-year-old woman, gravida 1 para 0. She visited her previous hospital at 17 weeks of gestation because of massive genital bleeding. A varicose vein was found in the uterine cervix, and the bleeding site was sutured to stop bleeding. However, the bleeding recurred at 28 weeks of gestation, and the patient was transferred to our hospital. There was no massive bleeding after transfer. We decided to perform a scheduled cesarean section because of the possibility of massive hemorrhage from varicose vein. However, we had to perform an emergency cesarean section due to premature rupture of the membranes at 36+3 weeks of gestation. The intraoperative blood loss was 1166 g. Both the mother and the child were doing well, and the varicose vein disappeared after the operation. Many studies have reported that bleeding from cervical varices can be managed via gauze compression or suturing of the cervix. However, suture hemostasis may be effective for bleeding in relatively early pregnancy, as in this case. In addition, there are many cases of excessive bleeding at the time of parturition, and thus, it is important to prepare for such cases.