Vaginal delivery in the presence of huge vulvar varicosities: a case report with MRI evaluation

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• 作者：Nozomi Furuta ; Eiji Kondoh ; ^{kondo@kuhp.kyoto-u.ac.jp} ; Shigehito Yamada ; Kaoru Kawasaki ; Akihiko Ueda ; Haruta Mogami ; Ikuo Konishi
• 关键词：Mode of delivery ; MRI ; Pregnancy ; Vulvar varicosity
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：167
• 期：2
• 页码：127-131
• 全文大小：1094 K

文摘

Vulvar varicosities are generally not an indication for a caesarean section but in a rare case of severe vulvar varicosities, it would be a controversial issue whether to perform a caesarean section for fear they might rupture during a vaginal delivery. We present a case of huge vulvar varicosities during pregnancy. MRI revealed obstruction of the internal iliac system by the gravid uterus and subsequent incompetence of a collateral pathway via the round ligament vein that emptied into the ovarian vein. The patient went into labour at 38 weeks, and successfully vaginally delivered a baby. The vulvar varicose veins became compressed by the foetal head from the inside, and markedly diminished in size during crowning and after delivery. Women with vulvar varicosities can be allowed to attempt a vaginal birth regardless of their severity. The use of MRI aids in the overall anatomical understanding of vulvar varicosities in pregnancy.