Cervical Varices Presenting as Vaginal Bleeding: A Description of Two Cases and A Management Plan

Background: Varicose veins are common in pregnancy. However, potentially life-threatening uterine cervical varices have rarely been reported and there are currently no guidelines for their management. Cases: We present two cases of cervical varices found in the setting of second and third trimester bleeding, report on the clinical outcomes and propose a management plan. Both of our patients were delivered between 38-39 weeks gestation and required interdisciplinary meetings between Obstetrics and Gynecology, Anesthesiology, Neonatology and Interventional Radiology to prepare for delivery. Conclusion: For patients in which varices are found inside the cervix, we recommend consideration of second trimester cerclage followed by serial ultrasound and scheduled cesarean delivery. Vascular embolization should also be considered