En bloc hysterectomy for treatment of symptomatic cervical varix in the early second trimester

摘要

The authors present a case of a cervical varix with morbidly adherent placentation treated with total abdominal hysterectomy. A 38-year-old presented at 15 weeks gestation with heavy painless vaginal bleeding and was found to have complete placenta previa and a cervical varix. After recurrent episodes of heavy bleeding requiring transfusion, she elected pregnancy termination. She underwent en block total abdominal hysterectomy with the fetus in utero at 18 weeks gestation. Pathology revealed dilated vessels at the cervical os and placenta percreta. The authors conclude that en bloc abdominal hysterectomy may be a reasonable management option to reduce hemorrhage risk in patients with a symptomatic cervical varix in the setting of a morbidly adherent placenta.