Cervical varicosities and placenta praevia.

INTRODUCTION

Cervical varicosities (CVs) have been reported infrequently in pregnancy and have been associated with significant antepartum and postpartum haemorrhage. The most common association with CVs in pregnancy in the literature is placenta praevia.

AIMS: To further investigate the association between placenta praevia and CVs.

METHODS

A retrospective audit of all cases of placenta praevia that had an ultrasound in the Feto-Maternal Unit at Liverpool Hospital over the period January 2001 to January 2012. Patient outcomes were obtained from the hospital paper and electronic medical records, including mode of delivery and blood loss.

RESULTS

Eighty-four cases of placenta praevia were identified, and 78 had saved images that were reviewed. 51 of these 78 cases had transvaginal ultrasound (TVUS) images, which identified nine further cases of cervical varicosities. All cases of CVs were complicated by APH and delivered by caesarean section. There was no significant difference in the blood loss at delivery between the placenta praevia with CVs and those without (925 vs 870 mLs P = 0.3877).

CONCLUSIONS

Cervical varicosities are not as rare as the literature would suggest. The clinical relevance of the additional finding of CV on TVUS in cases of placenta praevia is questionable.