Large vaginal varicosities in the pregnancy without any known systemic disease: a rare case report

Vaginal varices during pregnancy is a rare condition. Only a few cases have been reported in the literature. Most vaginal varices are asymptomatic, but some are associated with a sense of local mass, or severe discomfort and spontaneous vaginal bleeding. A 26-year-old woman was admitted for spontaneous vaginal bleeding at 38 weeks’ gestation. Upon pelvic inspection, we observed dilated vascular structure on the sub-urethral vaginal wall, and the trans-labial ultrasound imaging revealed a blood flow along the vaginal area, confirming the presence of a vaginal varicosity (Figure 3). We concluded that the mass was large vaginal varicosities as there was no discernible etiolgy. Instead of a normal delivery, we performed a cesarean section to prevent the potential risk of the profuse vaginal bleeding. For long-term management, close observation in postpartum period was recommended. Spontaneous resolution is a potential outcome and this is what our patient experienced

Safety and effectiveness of intravenous iron sucrose versus standard oral iron therapy in pregnant women with moderate anaemia in India

Background: Aim of the study was to diagnose and treat pregnant females with iron deficiency anaemia, to reduce the complications associated with anaemia in pregnancy and to compare the efficacy, safety and side effects of iron sucrose with ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy. Methods: The subjects for study were enrolled on fulfilling the inclusion and exclusion criteria. After detailed history, examination and investigations of patient the dose of intravenous iron sucrose was calculated by using the following formula: dose of iron: 2.4 x Hb deficit (11-patient’s actual Hb) x body weight in kg + 500. The following investigations were done on day 1: (a) complete blood count (CBC)- Hb, MCV, MCH, MCHC and PCV; (b) urine examination. Patients was randomly allocated into two groups. Group-A: oral group- containing 150 pregnant females. Group-B: intravenous group- containing 150 pregnant females. Results: Majority of women (48%) were from lower middle class and lower class (30%). Only 5.3% were from higher socioeconomic class (p value 0.0001). Maximum women (60%) were primigravida and 40% were multigravida. which indicates that most ladies enter pregnancy with poor iron reserves. Improvement in the mean haemoglobin levels after 4 weeks of treatment was statistically significant in both the groups (p value 0.0001). Similarly rise in the mean PCV levels after 4 weeks of the treatment was significantly associated in both the groups (p value 0.0001). There was slight rise in the mean MCV and MCH after 4 weeks. Peripheral blood film had changed from microcytic hypochromic to normocytic normochromic after 4 weeks of the treatment in both the group (p value 0.004). Presence of side effects with the oral and parenteral treatment were 81.3% and 12% respectively (p value 0.0001). Conclusions: From our study, it can be concluded that intravenous iron sucrose has lesser side effects along with better absorption