Epistaxis In The Parturient

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Medically Challenging Case Report Poster 


Jenessa Job  
New York Presbyterian Hospital/Weill-Cornell Medical Center


Alaeldin Darwich  
New York Presbyterian Hospital/Weill-Cornell Medical Center
Jaime Aaronson  
New York Presbyterian Hospital/Weill-Cornell Medical Center


35-year-old nulliparous woman presented at term for cesarean section. Pregnancy was complicated by spontaneous severe epistaxis with hemoglobin drop to 6 g/dL requiring transfusion and ligation of the right sphenopalatine artery. Epistaxis recurred intermittently throughout pregnancy, and the patient was admitted for stabilization of bleeding via nasal packing. Multidisciplinary care was coordinated with otolaryngology and hematology. The patient had no history of significant bleeding, and hematologic workup was unrevealing. Cesarean delivery was planned to avoid Valsalva, under spinal anesthesia. Oxymetazoline spray and otolaryngology were immediately available however no further bleeding occurred. There were no complications.

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Enter up to two references.

1. Piccioni MG, Derme M, Salerno L, Morrocchi E, Pecorini F, Porpora MG, and Brunelli R. Management of Severe Epistaxis during Pregnancy: A Case Report and Review of the Literature. Case Reports in Obstetrics and Gynecology. 2019; vol 2019, article ID 5825309, 3 pages.
2. Lomax S, Edgcombe H. Anesthetic implications for the parturient with hereditary hemorrhagic telangiectasia. Canadian Journal of Anesthesia. 2009; 56(5): 374-384.