Severe Vulvovaginal Varicosities in Pregnancy- A 33-year-old woman was admitted for induction of labor at 41 weeks 3 days of gestation. Before induction, the physical examination revealed venous varicosities on the right labia majora and minora and the right vaginal wall (Panel A)....Vulvovaginal varicosities are common in pregnancy and usually appear in the second trimester. Possible mechanisms include compression of the inferior vena cava by the gravid uterus and hormonal changes. The presence of vulvar varicosities is not a contraindication for vaginal delivery, but clinical discretion regarding the route of delivery is required, depending on the size and location of the varicosities. In this instance, the patient underwent caesarean delivery without complications. The vulvar varicosities were substantially smaller after delivery (Panel B). #clinical #photo #NEJM #varicosities #vulvovaginal