Background: Large pelvic varicosities and an absence of the inferior vena cava below the renal veins were identified in pregnancy.
Case: A young woman with a history of hemitruncus repair in infancy was noted to have large pelvic varicosities on a transvaginal ultrasonogram in early pregnancy. Magnetic resonance imaging confirmed these findings. Her protein S activity was mildly depressed, and an methylene tetrahydrofolate reductase mutation was present with normal fasting homocysteine levels. Despite concerns regarding the presence of these varicosities and potential thrombotic and hemorrhagic complications, a spontaneous vaginal delivery was achieved.
Conclusion: Large pelvic varicosities may be present in women with congenital heart disease. Although these women are at risk for complications, vaginal delivery may be safely achieved.