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Management of prolonged epistaxis in pregnancy: case report

Published online by Cambridge University Press:  30 July 2013

K Cornthwaite ,
K Varadharajan ,
M Oyarzabal  and
H Watson
K Cornthwaite
Affiliation:
Department of Otorhinolaryngology, Medway Maritime Hospital, Gillingham, UK
K Varadharajan*
Affiliation:
Department of Otorhinolaryngology, Medway Maritime Hospital, Gillingham, UK
M Oyarzabal
Affiliation:
Department of Otorhinolaryngology, Medway Maritime Hospital, Gillingham, UK
H Watson
Affiliation:
Department of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, UK
*
Address for correspondence: Mr K Varadharajan, Department of Otorhinolaryngology, Medway Maritime Hospital, Gillingham ME7 5NY, UK Fax: 01634 830000 E-mail: kiranvarad@doctors.org.uk
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Abstract

Objectives:

To report a case of life-threatening epistaxis in a pregnant patient, describe the links between pregnancy and epistaxis, and discuss the management of such cases. Life-threatening epistaxis in pregnancy is rare, and there are no specific evidence-based guidelines regarding the management of these patients.

Case report:

A 31-year-old primigravida presented with severe epistaxis in the second trimester of her pregnancy. Conservative measures failed, thereby necessitating surgical intervention.

Conclusion:

This case illustrates the importance of a multidisciplinary approach in the management of a pregnant patient presenting with severe epistaxis, and highlights the surgical challenges presented in such a situation.

Keywords

EpistaxisPregnancyHELLP Syndrome
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 811 - 813
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Viehweg, TL, Roberson, JB, Hudson, JW. Epistaxis: diagnosis and treatment. J Oral Maxillofac Surg 2006;64:511–18CrossRefGoogle ScholarPubMed
2Dugan-Kim, M, Connell, S, Stika, C, Wong, C, Gossett, D. Epistaxis of pregnancy and association with postpartum hemorrhage. Obstet Gynecol 2009;114:1322–5CrossRefGoogle ScholarPubMed
3Howard, D. Life-threatening epistaxis in pregnancy. J Laryngol Otol 1985;99:95–6CrossRefGoogle ScholarPubMed
4Sobol, S, Frenkiel, S, Nachtigal, D, Wiener, D, Teblum, C. Clinical manifestations of sinonasal pathology during pregnancy. J Otolaryngol 2001;30:24–8CrossRefGoogle ScholarPubMed
5Jones, JE, Nguyen, A, Tabaee, A. Pyogenic granuloma (pregnancy tumor) of the nasal cavity. A case report. J Reprod Med 2000;45:749–53Google ScholarPubMed
6Kapella, M, Panosetti, E, Rombaux, P, Delos, M, Weynand, B. Lobular capillary haemangioma of the nasal cavity: observation of three specific cases. Acta Otorhinolaryngol Belg 2001;55:241–6Google ScholarPubMed
7Choudhary, S, MacKinnon, CA, Morrissey, GP, Tan, ST. A case of giant nasal pyogenic granuloma gravidarum. J Craniofac Surg 2005;16:319–21CrossRefGoogle ScholarPubMed
8Zarrinneshan, AA, Zapanta, PE, Wall, SJ. Nasal pyogenic granuloma. Otolaryngol Head Neck Surg 2007;136:130–1CrossRefGoogle ScholarPubMed
9Garg, R, Nath, MP, Bhalla, AP, Kumar, A. Disseminated intravascular coagulation complicating HELLP syndrome: perioperative management. BMJ Case Rep 2009;2009. Epub 2009 Apr 17CrossRefGoogle ScholarPubMed
10Geary, M. The HELLP syndrome. Br J Obstet Gynaecol 1997;104:887–91CrossRefGoogle ScholarPubMed
11McCrae, KR. Thrombocytopenia in pregnancy. In: Michelson, AD, ed. Platelets. New York: Elsevier, 2006;925–33Google Scholar
12Crider, KS, Cleves, MA, Reefhuis, J, Berry, RJ, Hobbs, CA, Hu, DJ. Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study. Arch Pediatr Adolesc Med 2009;163:978–85CrossRefGoogle ScholarPubMed
13Wilkinson, P, Van Dyke, C, Jatlow, P, Barash, P, Byck, R. Intranasal and oral cocaine kinetics. Clin Pharmacol Ther 1980;27:386–94CrossRefGoogle ScholarPubMed
14Chiu, Y, Brecht, KK, DasGupta, DS, Mhoon, EE. Myocardial infarction with topical cocaine anesthesia for nasal surgery. Arch Otolaryngol Head Neck Surg 1986;112:988–90CrossRefGoogle ScholarPubMed
15Foutz, SE, Kotelko, DM, Shnider, SM, Thigpen, JW, Rosen, MA, Brookshire, GL et al. Placental transfer and effects of cocaine on uterine blood flow and the fetus. Anesthesiology 1983;59:A422Google Scholar
16Iriye, BK, Asrat, T, Adashek, JA, Carr, MH. Intraventricular haemorrhage and maternal brain death associated with antepartum cocaine abuse. Br J Obstet Gynaecol 1995;102:68–9CrossRefGoogle ScholarPubMed
17Gouin, K, Murphy, K, Shah, PS. Effects of cocaine use during pregnancy on low birth weight and preterm birth: systematic review and metaanalyses. Am J Obstet Gynecol 2011;204:340.e1–12CrossRefGoogle ScholarPubMed
18Chasnoff, IJ, Burns, KA, Burns, WJ. Cocaine use in pregnancy: perinatal morbidity and mortality. Neurotoxicol Teratol 1987;9:291–3CrossRefGoogle ScholarPubMed