///2009 Abstract Details
2009 Abstract Details2019-08-03T15:55:31-06:00

Epistaxis of Pregnancy and Association with Post-Partum Hemorrhage

Abstract Number: 203
Abstract Type: Original Research

Melissa A Dugan-Kim MD, MPH1 ; Connell Sarah BS2; Gossett Dana MD3; Stika Catherine MD4; Wong Cynthia MD5

OBJECTIVE: To establish the prevalence of epistaxis among pregnant women and determine if epistaxis of pregnancy is associated with an increased risk of bleeding at time of delivery.

STUDY DESIGN: A cohort of 1,475 pregnant women presenting in labor, for induction of labor, or for cesarean section at term were asked to complete a survey about epistaxis and other traditional risk factors for bleeding. Their results were compared to those from a cohort of 275 non-pregnant women of reproductive age presenting for routine gynecologic care in order to establish the effect of pregnancy on the prevalence of epistaxis. To then determine the association between epistaxis of pregnancy and disorderd hemostasis, the rates of post-partum hemorrhage as obtained from the patients medical record were compared between pregnant women with and without epistaxis.

RESULTS: Final data analysis was performed on 1470 pregnant women and 275 non-pregnant women. The prevalence of epistaxis as defined by at least two active nose-bleeds was significantly increased in pregnant women (20.3% versus 6.2% p<.001). These women with epistaxis of pregnancy were at increased risk of post-partum hemorrhage compared with those women without epistaxis (10.7% versus 6.7%, p<.021). The increased risk of hemorrhage remained after controlling for cesarean section and after exclusion of those women who also reported epistaxis prior to pregnancy. Of note, other traditional risk factors for bleeding such as gingival bleeding, O blood type, easy bruising, or history of prior post-surgical or post-delivery bleeding were not associated with increased risk of post-partum hemorrhage.

CONCLUSIONS: Epistaxis is a common problem during pregnancy that may be associated with an increased risk of postpartum hemorrhage. As in the non-pregnant population, eliciting a history of active nosebleeds may help to identify women at risk of disordered hemostasis.

SOAP 2009