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    Uterine Varices During Pregnancy: Koji Matsuo, MD Tadashi Kimura, MD, PHD

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    Uterine Varices During Pregnancy: Koji Matsuo, MD Tadashi Kimura, MD, PHD

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    j.ajog.2007.05.010.pdf

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    Uterine Varices During Pregnancy: Koji Matsuo, MD Tadashi Kimura, MD, PHD

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    Images in Obstetrics www. AJOG.

    org

    Uterine varices during pregnancy


    Koji Matsuo, MD; Tadashi Kimura, MD, PhD

    CASE NOTES

    A 39 year old multiparous woman was prepared


    for a cesarean section, as indicated for placenta
    previa centralis with breech presentation of the
    fetus. As soon as the uterus was exposed, it was
    evident that the uterine venous plexus was ex-
    tremely distended over the anterior surface of
    the lower uterine segment. The patient had de-
    nied any medical complications, including ab-
    normal vaginal bleeding, and overall, her prena-
    tal course had been uneventful. Her obstetrical
    history included previous cesarean section with
    classical uterine incision for delivery of a fetus in
    transverse lie presentation.
    An extremely distended uterine venous plexus was visualized over the
    anterior surface of the lower uterine segment.

    CONCLUSIONS

    Severe varices of the uterine venous plexus as such, might be related to the abnormal
    were discovered in the lower uterine seg- vasculature typical of placenta previa. In
    ment. This finding required the surgeons addition, our patient’s history of classical
    to weigh their options for uterine incision cesarean section may have contributed
    before surgery could continue. Because an to the development of uterine surface
    incision in the lower uterine segment varices. In general, surgeons should be
    From the Department of Obstetrics and could have resulted in hemorrhage, a aware that patients whose pregnancies
    Gynecology, Osaka University, Osaka, Japan transverse incision was made in the uterine are complicated by placenta previa are at
    (Drs Matsuo and Kimura), and the corpus to prevent bleeding from the swol- risk of varices of the uterine venous
    Department of Obstetrics, Gynecology, and len blood vessel. Immediately after deliv- plexus as well as cervical varices.2 f
    Reproductive Sciences, University of ery of the fetus and placenta, the varices
    Maryland School of Medicine, Baltimore, resolved. The patient’s estimated blood REFERENCES
    MD (Dr. Matsuo). loss was 760 mL. 1. Yoshimura K, Hirsch E, Kitano R, Kashimura
    Cite this article as: Matsuo K and Kimura T. Uterine Cervical varices, which are related to M. Cervical varix accompanied by placenta pre-
    varices during pregnancy. Am J Obstet Gynecol 2007; placenta previa, can lead to life-threaten- via in twin pregnancy. J Obstet Gynaecol Res
    197;112.e1. 2004;30:323-5.
    ing hemorrhage during pregnancy.1 The
    0002-9378/$32.00 2. Hashimoto K, Tabata C, Ueno Y, Fukuda H,
    large varices we suddenly encountered in Shimoya K, Murata Y. Spontaneous rupture of
    © 2007 Mosby, Inc. All rights reserved.
    doi: 10.1016/j.ajog.2007.05.010 our patient’s lower uterine segment uterine surface varicose veins in pregnancy: a
    could be a subtype of cervical varices and case report. J Reprod Med 2006;51:722-4.

    112.e1 American Journal of Obstetrics & Gynecology JULY 2007

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