Severe vulvar varicosities in pregnancy with the detailed sequential clinical course and management considerations: A case report

Abstract

Vulvar varicosities occur in approximately 4 % of pregnant women and typically resolve within a few months postpartum without treatment. Careful intrapartum management is essential because of the risk of massive haemorrhage due to dilated veins. Only a few studies have documented detailed changes in vulvar varicosities during the antepartum, intrapartum, and postpartum periods. This report presents the case of a pregnant woman who developed large vulvar varicosities at approximately 20 weeks of gestation. The varicosities increased in size until 28 weeks of gestation and then remained stable until delivery. The patient underwent a successful vaginal delivery, with an estimated blood loss of 1070 mL. Postpartum haemorrhage due to uterine atony was confirmed, and uterine balloon tamponade was performed. Vulvar varicosities regressed rapidly after delivery and continued to diminish progressively over the postpartum period. Complete resolution had been achieved by 1 month postpartum. This report details the progression of vulvar varicosities during the antepartum, intrapartum, and postpartum periods, and highlights the need for appropriate delivery management to prevent complications.