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Print ISSN: 2754-3242 Online ISSN: 2754-1304
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July-August 2025 Volume 5 Issue 4

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Case Report Open Access

Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case

  • Authors:
    • Anna Thanasa
    • Efthymia Thanasa
    • Ioannis-Rafail Antoniou
    • Alexandros Leroutsos
    • Ioannis Thanasas
  • View Affiliations / Copyright

    Affiliations: Department of Health Sciences, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece, Department of Obstetrics and Gynecology, General Hospital of Trikala, 42100 Trikala, Greece
    Copyright: © Thanasa et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 35
    |
    Published online on: April 10, 2025
       https://doi.org/10.3892/mi.2025.234
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Abstract

Cervical varices during pregnancy are a rare clinical entity. The rupture of cervical varices in pregnant women may be associated with fetal loss following the termination of the pregnancy or pre‑term delivery, in the case that it occurs in the presence of a viable fetus. The present study describes a case of pregnancy termination by caesarean section due to massive vaginal bleeding following the rupture of cervical varices in the second trimester. A 26‑year‑old primigravida, with a history of placenta previa, presented to the hospital at 21 weeks of gestation, reporting significant painless vaginal bleeding. A transvaginal Doppler ultrasonography revealed elongated formations in the endocervix with increased vascularization, suggestive of dilated vascular structures. There were no obvious signs of peripheral abruption of the placenta previa. In the operating room, a thorough examination of the cervix revealed enlarged blood vessels with a variceal appearance, protruding through the cervical canal to the external cervical os, which were actively bleeding. Upon palpation of the vascular structures, torrential vaginal bleeding ensued. After temporarily controlling the bleeding with the use of several hemostatic forceps, the termination of the pregnancy was performed via cesarean section. To manage the severe intraoperative bleeding, blood transfusion was administered, and an utero‑cervico‑vaginal tamponade was performed using gauze packing. Blood transfusions were also required in the immediate post‑operative period to stabilize the hemodynamic condition of the patient. The patient was discharged from the clinic on the 5th post‑operative day. At 20 days thereafter, a clinical examination and transvaginal Doppler ultrasonography revealed normal cervical findings. On the whole, the case described herein highlights the importance of transvaginal Doppler ultrasonography in the early diagnosis of cervical varices. It also underscores the need for a differential diagnosis between bleeding from cervical varices and vaginal bleeding caused by peripheral placental abruption, with the goal of minimizing maternal and perinatal morbidity and mortality.
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Copy and paste a formatted citation
Spandidos Publications style
Thanasa A, Thanasa E, Antoniou I, Leroutsos A and Thanasas I: Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case. Med Int 5: 35, 2025.
APA
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., & Thanasas, I. (2025). Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case. Medicine International, 5, 35. https://doi.org/10.3892/mi.2025.234
MLA
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., Thanasas, I."Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case". Medicine International 5.4 (2025): 35.
Chicago
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., Thanasas, I."Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case". Medicine International 5, no. 4 (2025): 35. https://doi.org/10.3892/mi.2025.234
Copy and paste a formatted citation
x
Spandidos Publications style
Thanasa A, Thanasa E, Antoniou I, Leroutsos A and Thanasas I: Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case. Med Int 5: 35, 2025.
APA
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., & Thanasas, I. (2025). Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case. Medicine International, 5, 35. https://doi.org/10.3892/mi.2025.234
MLA
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., Thanasas, I."Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case". Medicine International 5.4 (2025): 35.
Chicago
Thanasa, A., Thanasa, E., Antoniou, I., Leroutsos, A., Thanasas, I."Massive vaginal bleeding caused by ruptured cervical varices associated with fetal loss in the second trimester of pregnancy: A report of a rare case". Medicine International 5, no. 4 (2025): 35. https://doi.org/10.3892/mi.2025.234
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