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
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- 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 :
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- 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
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- 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
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- 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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