{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T15:09:10Z","timestamp":1768489750283,"version":"3.49.0"},"reference-count":14,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>During pregnancy, total blood volume increases by about 40%. As gestation advances, blood volume to the pelvic region increases significantly. Due to the enlarging uterus, the venous return from the lower body decreases with advancing gestational age. The pooling and stasis of blood in the lower body can lead to the formation of varices, affecting the lower extremity, vulva, and vaginal regions. Varicosities in the lower extremities and vulva are not uncommon and often asymptomatic. Vulvar varicosities are more common in women with varicosities in the lower extremities. On the other hand, vaginal varicosities are extremely rare and mentioned only in case reports. Although asymptomatic, vaginal varicosities could become a concern for hemorrhage risk during vaginal delivery. There is little information in the current medical literature about the diagnosis and management of large vaginal varicosities during pregnancy.<\/jats:p>\n                  <jats:p>Design We present a case of a primigravida with very large prolapsing vaginal varicosities that presented as a large external mass at 36 weeks of gestation.<\/jats:p>\n                  <jats:p>The patient was managed expectantly during the antenatal period. She was delivered via an elective scheduled cesarean section. An almost complete resolution of the vaginal varices was noted at 6 hours postoperatively, with complete resolution reported on postoperative day 22.<\/jats:p>\n                  <jats:p>Due to the rarity of the condition, we hope to add our experience to the literature.<\/jats:p>","DOI":"10.1055\/a-2765-7948","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:13:16Z","timestamp":1765239196000},"page":"e7-e9","source":"Crossref","is-referenced-by-count":0,"title":["Pregnancy-Induced Isolated Severe Vaginal Varicosities: A Case Report and Literature Review"],"prefix":"10.1055","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8005-9276","authenticated-orcid":false,"given":"Hanna","family":"Brancaccio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itishree","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Srimanta Sankardeva University of Health Sciences, Guwahati, Assam, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Crary","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Washington, Seattle, Seattle, Washington, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asha","family":"Rijhsinghani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Washington, Seattle, Seattle, Washington, United States"},{"name":"Morristown Medical Center, Morristown, New Jersey, United State"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"651","DOI":"10.4103\/ija.IJA_458_18","article-title":"Physiological and anatomical changes of pregnancy: Implications for anaesthesia","volume":"62","author":"P Bhatia","year":"2018","journal-title":"Indian J Anaesth"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ejogrb.2012.11.024","article-title":"Vaginal delivery in the presence of huge vulvar varicosities: a case report with MRI evaluation","volume":"167","author":"N Furuta","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"210","DOI":"10.4103\/0019-5154.127757","article-title":"Vulvovaginal varicosities: an uncommon sight in a dermatology clinic","volume":"59","author":"S Jindal","year":"2014","journal-title":"Indian J Dermatol"},{"issue":"01","key":"ref4","first-page":"35","article-title":"A case of vaginal varices that caused massive bleeding after vaginal delivery","volume":"64","author":"N Kikuchi","year":"2016","journal-title":"The Shinshu Medical Journal"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/S0002-9378(16)39907-0","article-title":"Extensive varix of vulva and vagina in full term pregnancy; delivery by cesarean section","volume":"51","author":"S S Adler","year":"1946","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5468\/KJOG.2012.55.1.29","article-title":"A case of vaginal varix during pregnancy","volume":"55","author":"J H Kim","year":"2012","journal-title":"Korean Journal of Obstetrics and Gynecology"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"2682","DOI":"10.1172\/JCI107462","article-title":"A study of angiotensin II pressor response throughout primigravid pregnancy","volume":"52","author":"N F Gant","year":"1973","journal-title":"J Clin Invest"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"2394695","DOI":"10.1155\/2018\/2394695","article-title":"Large vaginal varicosities in the setting of pregnancy without known hepatic or vascular risks: a case report and review of the literature","volume":"2018","author":"M Sueyoshi","year":"2018","journal-title":"Case Rep Obstet Gynecol"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1111\/j.1432-2277.2005.00232.x","article-title":"Vaginal bleeding complicating portal hypertension: a particular entity - report of two cases and review of the literature","volume":"18","author":"G Orlando","year":"2005","journal-title":"Transpl Int"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1002\/lt.21506","article-title":"Vaginal varices with massive hemorrhage in a patient with nonalcoholic steatohepatitis and portal hypertension: successful treatment with liver transplantation","volume":"14","author":"P P McHugh","year":"2008","journal-title":"Liver Transpl"},{"issue":"01","key":"ref11","first-page":"75","article-title":"Varicosities of vulva during pregnancy- a rare case report","volume":"16","author":"V Choudhary","year":"2017","journal-title":"IOSR J Dent Med Sci"},{"key":"ref12","first-page":"723467","article-title":"Successful management of pregnancy complicated by Klippel-Trenaunay syndrome using MR angiography-based evaluation","volume":"2011","author":"R Tanaka","year":"2011","journal-title":"Case Rep Obstet Gynecol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"706850","DOI":"10.1155\/2010\/706850","article-title":"Klippel-Trenaunay syndrome and pregnancy","volume":"2010","author":"T G\u00fcngor G\u00fcndo\u011fan","year":"2010","journal-title":"Obstet Gynecol Int"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.18203\/2320-1770.ijrcog20211556","article-title":"Spontaneous rupture of vaginal varicose veins mimicking placenta praevia","volume":"10","author":"R G Yaliwal","year":"2021","journal-title":"Int J Reprod Contracept Obstet Gynecol"}],"container-title":["American Journal of Perinatology Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2765-7948.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:13:22Z","timestamp":1768436002000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2765-7948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":14,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2026,1,14]]},"published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2765-7948","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2157-6998","2157-7005"],"issn-type":[{"value":"2157-6998","type":"print"},{"value":"2157-7005","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12,8]]},"published":{"date-parts":[[2025,12,8]]}}}