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Cervical varix and low-lying placenta

Case contributed by Rodrigo Santillan
Diagnosis certain

Presentation

Presented with slight PV bleeding and pelvic pain at 26 weeks gestation

Patient Data

Age: 35 years
Gender: Female
ultrasound

Cervix with a functional length of 28 mm with a hypoechoic tubular structure inside the cervical canal, after applying Doppler color, venous type pattern is seen with venous wave spectral mode that increases with Valsalva maneuver.

Case Discussion

The frequency of varicose veins in the cervix during pregnancy is rare, with approximately 15 cases being reported in the literature at the time of writing (2018). The risk of bleeding in these cases is very high. Risk factors include low-lying placenta and diethylstilbestrol exposure. In our case, the low insertion of the placenta is the major risk factor, which matches with the literature. This is caused by a low Insertion placenta, that increases the flow of cervical venous vessels.

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