<![CDATA[Background: Epistaxis during pregnancy is usually associated with hormonal and vascular alterations of the nasal mucosa, but persistent or severe bleeding may result in substantial blood loss and aggravate anemia, particularly in patients with recurrent episodes. Case Report: A 33-week primigravida (G1P0A0) presented with recurrent epistaxis accompanied by oral blood expectoration. She had experienced recurrent epistaxis since childhood, chronic anemia, and previous blood transfusions. Laboratory evaluation showed severe microcytic hypochromic anemia (hemoglobin 7.9 g/dL, MCV 74.2 fL, MCH 21.7 pg, MCHC 29.3%) with a normal platelet count. Treatment included transfusion of three units of packed red blood cells and conservative therapy. Discussion: Pregnancy-related vascular changes likely exacerbated chronic bleeding, causing secondary iron deficiency anemia. Differential diagnoses included rhinitis gravidarum, coagulation disorders, hereditary hemorrhagic telangiectasia, and thalassemia. Conclusion: Epistaxis during pregnancy may indicate conditions beyond physiological gestational changes. A multidisciplinary approach is essential to establish the underlying diagnosis and prevent maternal and fetal complications.]]>
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