Vaginal varicose veins in advanced pregnancy: a rare occurrence

Abstract

Varicose veins are common in pregnancy due to hormonal influences and increased venous pressure; however, vaginal varicosities are a rare and often underreported manifestation. Their presence poses diagnostic challenges and may influence obstetric management because of the potential risk of hemorrhage during vaginal delivery. We present a case of vaginal varicosity in a 32year old G3P2+0, 2 alive. She presented with complain of painless vaginal swelling noticed incidentally at 17 weeks of gestation. The swelling persisted then remained stable. She also had varicose veins on her lower limbs bilaterally. Vaginal examination revealed a bluish soft, non-tender, compressible swellings involving the vaginal walls. Doppler Ultrasound Scan revealed a mass in the vaginal walls with high flow on doppler interrogation/augmentation and Valsalva maneuver. An assessment of vaginal varicosity was made. She was counseled on the mode of delivery and had elective caesarean section on account of vaginal varicose veins and coexisting breech presentation at term. The swelling started regressing after delivery and by 6 weeks post-partum it had resolved completely.