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June 28, 2026
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Abstract

BACKGROUND: Superficial serosal uterine varicosity (SSUV) is a rare anomaly commonly seen in non-pregnant individuals, and its presence in pregnancy is seldom reported. Here we present a case of SSUV that was accidentally discovered during an elective Cesarean delivery, causing unexpected bleeding. CASE PRESENTATION: A 30-year-old pregnant woman at 37 weeks of gestation with three previous Cesarean deliveries attended our clinic for an elective appointment; her past medical and surgical history was unremarkable. Laboratory investigations were normal, and Doppler ultrasound showed a fundo-anterior placenta, normally situated, with no signs of placenta accreta. During an otherwise uneventful surgery, a brisk haemorrhage occurred near the incision site following complete placental delivery. A dilated tortuous vein was identified as the bleeding source, and hemostasis was secured by ligation and oxytocic drugs. CONCLUSION: SSUV is an uncommon cause of bleeding during Cesarean delivery; as it escapes antenatal imaging, it imposes diagnostic challenges and increases bleeding and transfusion demands.

Keywords

Serosal Uterine Varicosity Cesarean section Hemostasis Doppler ultrasound

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Copyright (c) 2026 Wassan Nori, Maryam Abduljabbar Hammood, Manal Madany Abdalqader, Ahmed Atia

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