ABSTRACT
A nosebleed or epistaxis is blood loss commonly from the front of the nose. Nosebleeds are common and occur in pregnancy. Nosebleeds are common in children, nearly always anterior in location and usually brief. In older patients, bleeding from the nose can be more severe, especially if the bleeding is from the back of the nose. Anterior nosebleeds occur from Little’s area, a watershed of arteries in front of the nasal septum. Posterior nosebleeds are less common but much more severe, and originate from the sphenopalatine artery, a terminal branch of the maxillary artery. Pregnancy hormones affect the nasal mucosa, nasal cycle, and mucociliary nasal transport time, producing rhinorrhoea and nasal obstruction. Control of severe nosebleeds can require volume replacement and resuscitation, as well as addressing the underlying cause. Severe nosebleeds may be associated with bleeding from the mouth and haematemesis. Bed rest is important in severe nosebleeds, with appropriate deep venous thrombosis prophylaxis.
