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Secondary Post Partum Haemorrhage

Published by : ayurdoctor on:27-11-13 03:56 PM

Secondary Post Partum Haemorrhage

  • 31y Female patient delivered one month back came with complaints of P/V bleeding since 4 hours. Soakage of 7-8 pads

  • H/o giddiness

  • O/H : P2 L2



    • Both full term normal hospital deliveries.

    • Both male children. First child 1 year old. Second child 1 month old.



  • Past, Personal, family H/O Not significant.

  • O/E :



    • G-C fair

    • A febrile

    • P 96/min

    • BP 100/60 mmHg.

    • Pallor + +

    • S/E RS - NAD

    • CVS - NAD



  • P/A: Soft.






Bowel sounds - Normal

  • P/S: Vulva Normal



    • Vaginal walls normal

    • Cx Lips normal.

    • Growth 4 X 4cm reddish brown colour protruding through cervix.

    • Highly vascular, bled on touch.



  • P/V: Uterus anteverted, bulky



    • Cx Soft

    • Fornices free non tender. Growth 4 X 4cm protruding through cervix was friable, bled on touch

    • The probe can be passed from the sides of the growth ( rule out puerperal uterine inversion).

    • Thick pedicle felt above the growth








Investigations

  • Hb 6.4gm%

  • Bl. Group B+ve.

  • USG : Bulky uterus e/o growth in cervix.






Rx:

  • 1 Bottle Blood Transfusion given preoperatively.

  • Decision of immediate Abdominal Hysterectomy taken.

  • Abdominal Hysterectomy done. Post operative 1bottle blood transfusion given.

  • Specimen sent for HPR.








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