Intrapartum hemorrhage secondary to circumferential ectopic cervical deciduosis: A case report

INTRODUCTION: Intrapartum hemorrhage constitutes a life-threatening obstetric complication and can have multiple etiologies. Some rare causes of intrapartum bleeding warrant consideration when assessing these patients. This case study represents one such instance where cervical deciduosis presented with bleeding relatively early in labor and explores the management that followed. CASE: A review was requested for a woman undergoing induction of labor due to intrapartum hemorrhage. On vaginal examination, a mass was palpated attached to the cervix which extended from 3 o'clock to 9 o'clock. During emergency caesarean section, a circumferential, sessile, polypoidal mass was attached to the superior margin of the internal cervical os. Histopathology revealed cervical deciduosis. CONCLUSION: With regard to this patient, it is unknown if this episode of cervical deciduosis (and the associated intrapartum hemorrhage) was the sole cause of fetal distress or if it was an incidental finding. It is worth remembering that although placental causes of intrapartum hemorrhage are foremost in our minds, there can be other structures and causes that lead to intrapartum bleeding. This shows the complexity that may be associated with intrapartum care.