{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:33:02Z","timestamp":1760985182450,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,9,8]]},"abstract":"<jats:p>Although epistaxis is common during pregnancy, large volume epistaxis is rare. Many standard epistaxis management options are limited in pregnancy due to absolute or relative contraindications. Ear, nose and throat surgeons need to be aware of what options can be used safely and effectively. We present a case of a 32-year-old woman, 32\u2005weeks pregnant, who was admitted with heavy epistaxis refractive to conservative management. Several potential interventions including bismuth iodoform paraffin paste (BIPP) and Floseal were contraindicated or involved additional risk in pregnancy necessitating unorthodox management. This challenging case highlights suitable alternatives for managing large volume epistaxis during pregnancy, as well as discussing the differential diagnosis and relevant investigations.<\/jats:p>","DOI":"10.1136\/bcr-2014-203892","type":"journal-article","created":{"date-parts":[[2014,10,9]],"date-time":"2014-10-09T10:34:34Z","timestamp":1412850874000},"page":"bcr2014203892","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Torrential epistaxis in the third trimester: a management conundrum"],"prefix":"10.1136","volume":"2014","author":[{"given":"Rosa Elizabeth Mary","family":"Crunkhorn","sequence":"first","affiliation":[{"name":"Queen Elizabeth Hospital, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alistair","family":"Mitchell-Innes","sequence":"additional","affiliation":[{"name":"Department of ENT, Shrewsbury and Telford Hospitals, Telford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jameel","family":"Muzaffar","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat Surgery, Burton Hospital NHS Foundation Trust, Burton upon Trent, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,10,9]]},"reference":[{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181bea830"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.2","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2001.20906"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.3","doi-asserted-by":"publisher","DOI":"10.3109\/00016488509119150"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.4","first-page":"811","article-title":"Management of prolonged epistaxis in pregnancy: case report","volume":"127","author":"Cornthwaite","year":"2013","journal-title":"J Otolaryngol"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.5","first-page":"229","article-title":"Hypovolaemic shock secondary to epistaxis in pregnancy","volume":"22","author":"Cooley","year":"2002","journal-title":"J Obstet Gynaecol"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2007.09.003"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.7","doi-asserted-by":"publisher","DOI":"10.2500\/ar.2012.3.0028"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.8","first-page":"350","article-title":"ENT issues in pregnancy","volume":"151","author":"Lippincott","year":"1999","journal-title":"J La State Med Soc"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.9","doi-asserted-by":"publisher","DOI":"10.1080\/01443610902952562"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(98)00150-1"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.11","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(86)90155-3"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.12","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/014556139907800815","article-title":"Case report of a bleeding nasal polyp during pregnancy","volume":"78","author":"Scott","year":"1999","journal-title":"Ear Nose Throat J"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.13","first-page":"70","article-title":"Nasal septal haemangioma in pregnancy","volume":"65","author":"Noorizan","year":"2010","journal-title":"Med J Malaysia"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.14","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811407572"},{"key":"2025082623015789000_2014.oct09_1.bcr2014203892.15","first-page":"304","article-title":"Floseal hemostatic matrix in persistent epistaxis: prospective clinical trial","volume":"39","author":"Cote","year":"2010","journal-title":"J Otolaryngol Head Neck Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-203892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:02:11Z","timestamp":1756274531000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-203892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,9]]},"references-count":15,"alternative-id":["10.1136\/bcr-2014-203892"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-203892","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2014,10,9]]}}}