medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 08

<< Back

Ginecol Obstet Mex 2020; 88 (08)

Refractory severe epistaxis during pregnancy: a case report and a literature review

Azcona-Sutil L, Miceli A, Barroso-Castro JL, Cabezas-Palacios MN

Language: Spanish
References: 15
Page: 562-568
PDF size: 344.06 Kb.


ABSTRACT

Background: Epistaxis is a frequent emergency, which prevalence during pregnancy is three times higher than the general female population. It is usually managed with conservative measures, but sometimes more aggressive treatments like surgery may be required. Due to the limited bibliography currently available, new cases and their management should be recorded in order to assess outcomes.
Case Report: A 37-week-old pregnant woman went to the Emergency Department with an epistaxis that did not stop despite the use of conservative techniques. As a result of progressive anemization a sphenopalatine artery ligation was required to stop the bleeding. A cesarean section was performed for premature rupture of membranes and the impossibility of Valsalva maneuver. A male infant was born with APGAR test results of 9-10-10. During follow up the patient presented changes in the anatomy of her paranasal sinuses caused by the sphenopalatine artery ligation and is being followed up by Ear-Nose-Throat specialist.
Conclusion: Epistaxis during pregnancy rarely leads to maternal and/or fetal involvement; it is therefore essential to know all treatments available as well to record new cases and their management to increase knowledge about this uncommon but severe pathology.


REFERENCES

  1. Viehweg TL, et al. Epistaxis: Diagnosis and treatment. J Oral Maxillofac Surg 2006;64(3):511-518. doi: 10.1016/j. joms.2005.11.031.

  2. Dugan-Kim M, et al. Epistaxis of pregnancy and association with postpartum hemorrhage. Obstet Gynecol 2009;114(6):1322-5. doi: 10.1097/AOG.0b013e3181bea830.

  3. Piccioni MG, et al. Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature. Case Rep Obstet Gynecol 2019;2019:5825309. doi: 10.1155/2019/5825309.

  4. Crunkhorn RE, et al. Torrential epistaxis in the third trimester: a management conundrum. BMJ Case Rep 2014;2014:bcr2014203892. doi: 10.1136/bcr-2014-203892.

  5. Howard DJ. Life-threatening epistaxis in pregnancy. J Laryngol Otol 1985;99(1):95-96. doi: 10.1017/s002221510009633x.

  6. Alalula LS, et al. Intranasal Lobular Capillary Hemangioma with Multiple Sites of Origin during Pregnancy: A Case Report and Literature Review. Case Rep Otolaryngol 2018;2018:7413918. doi: 10.1155/2018/7413918.

  7. Noorizan Y, et al. Nasal septal haemangioma in pregnancy. Med J Malaysia 2010;65(1):70-1. https://www.ncbi.nlm. nih.gov/pubmed/21265255

  8. Kumar R, et al. Ear, nose, and throat manifestations during pregnancy. Otolaryngol Head Neck Surg 2011;145(2):188- 198. doi: 10.1177/0194599811407572.

  9. Cornthwaite K, et al. Management of prolonged epistaxis in pregnancy: case report. J Laryngol Otol 2013;127(8):811- 3. doi: 10.1017/S0022215113001576.

  10. Goldstein G, et al. Rhinologic issues in pregnancy. Allergy Rhinol 2012;3(1):13-15. doi: 10.2500/ar.2012.3.0028.

  11. Álvarez MP, et al. Epistaxis incoercible secundaria a embarazo. Acta Med 2015;13(3). https://www.medigraphic. com/cgi-bin/new/resumen.cgi?IDARTICULO=60682

  12. Hardy JJ, et al. Epistaxis in pregnancy-not to be sniffed at!. Int J Obstet Anesth 2008;17(1):94-95. doi: 10.1016/j. ijoa.2007.09.003.

  13. El Goulli M, et al. Severe epistaxis during pregnancy. A case history (author´s trans). J Gynecol Obstet Biol Reprod 1979;8(5):437-9. https://www.ncbi.nlm.nih.gov/ pubmed/541481

  14. Giambanco L, et al. The way a nose could affect pregnancy: severe and recurrent epistaxis. Pan Afr Med J 2019;24:34- 49. doi: 10.11604/pamj.2019.34.49.19558.

  15. Braithwaite JM, et al. Severe recurrent epistaxis causing antepartum fetal distress. Int J Gynaecol Obstet 1995;50(2):197-8. doi:10.1016/0020-7292(95) 02438-i.




2020     |     www.medigraphic.com