An Uncommon Cause of Antepartum Haemorrhage: A Case Study

Aim: To highlight the potential for benign lesions of the cervix uteri to present in bizarre unexpected ways during late pregnancy and the need for cautious evaluation to ensure optimal treatment is given, especially when life-altering decisions need to be made.

Presentation of Case: We present here a literature review and a case of 25 year old primigravida with twin gestation and antepartum hemorrhage (APH) initially thought to be due to cervical cancer but which turned out to be caused by chronic cervicitis.

Discussion: Obstetric hemorrhage remains the commonest cause of maternal mortality and morbidity in Nigeria. The occurrence of APH portends grave risks to the fetus and mother. A high risk of prematurity exists when bleeding occurs before term; a further risk of caesarean hysterectomy exists when a diagnosis of cervical cancer is suspected in women with APH. Infective cervical lesions such as cervicitis have been reported as causes of antepartum hemorrhage, but they are not significant enough to determine or affect obstetric outcome. Chronic cervicitis presenting as heavy antepartum hemorrhage leading to preterm delivery is a rare occurrence.

Conclusion: Infective lesions of the cervix are important benign causes of antepartum hemorrhage; the ability of chronic cervicitis to mimic exophytic cervical cancer is a consequence of physiologic changes in pregnancy which should be considered during patient evaluation. Cautious patient assessment should be done to ensure optimal care is given without undue risk to the fetus or mother.