scholarly journals Case report of venous air embolism in complete placenta previa in a case of lower segment caesarean section

Author(s):  
Korichi Noureddine ◽  
Lakshmi Ramanathan ◽  
Aboobaker Thode ◽  
Vipin Reghunatan ◽  
Vijyakumari .

Thromboembolic episodes in the pregnant and postpartum period in patients remain rare but fatal causes of maternal morbidity and mortality. They can be either venous air embolism, venous thrombo-embolism which include deep vein thrombosis and pulmonary embolism and last but not the least amniotic fluid embolism. The incidence of embolic episodes is more in LSCS patients than in patients coming for normal vaginal deliveries for all the type of embolisms, ranging from 10-97% for air embolisms depending on the surgical position and diagnostic tools with a potential for life threatening events, for venous thromboembolism (VTE)  it is 0.5-2.2%  patients per 1000 deliveries and increased  5-10-fold in pregnancy and 15-35% in postpartum period as compared to   the non-pregnant  women, the highest being during the 1st 3-6 weeks postpartum. After that the risk declines rapidly, although a small risk increase persists up to 12 weeks. After delivery, incidence of pulmonary embolism ranges from 0.11-0.73% per 1000 deliveries. It is rare, unpredictable, and unpreventable life-threatening complication of pregnancy. According to the International Cooperative Pulmonary Embolism registry, the death rate from massive PE among hemodynamically unstable patients is 52%. Last but not the least, incidence of amniotic fluid embolism ranges from 1/8000 to 1/15000. Delayed diagnosis, delayed treatment or inadequate treatment and inadequate thromboprophylaxis account for many of these deaths. Hence, early detection and proper management helps to prevent maternal mortality and morbidity in our patients. Also, thrombotic prophylaxis helps in preventing the fatal outcome and morbidity and mortality in our patients. Here, we report a case of a patient with complete placenta Previa scheduled for elective Lower segment caesarean section who developed venous air embolism (VAE) but with prompt detection and treatment a fatal outcome was prevented.

Author(s):  
Prachi Singh ◽  
Ritika Agarwal ◽  
Shweta Yadav

Background: Lower segment caesarean section is one of the commonest operations performed now a day.It has been seen that in cases with previous caesarean section there is increased maternal morbidity and mortality due to placenta previa, adherent placenta and caesarean hysterectomy.The present study was conducted to know the fetomaternal outcome and intra and immediate post-operative complications in cases with previous two lower segment caesarean section.Methods: The present study was conducted in TMMC Moradabad between January 2017-January 2018.Total 68 cases were previous two lower segment caesarean section were included in the study. Neonatal outcome and intraoperative and immediate postoperative complications were seen in these cases.Results: In the present study majority of the cases were in 30-34 years age group (39.7%), the maximum number of caesarean sections were done between gestational age of 37-39.6 weeks (47.1%). Intraoperatively adhesions between uterus, anterior abdominal wall and bladder was seen in less than half of the cases i.e. in 42.6% cases. Out of 68 cases with previous two lower segment caesarean operated 13 cases had placenta previa and 4 cases had adherent placenta.Conclusions: The present study shows that the maternal and perinatal morbidity and mortality is increased with increasing number of caesarean sections. So, there should be reduction in rate of primary caesarean section which can reduce the rate of placenta previa and adherent placenta in subsequent pregnancies.


Author(s):  
Dhananajay Borse ◽  
Binay Mitra ◽  
Aparna Sharma

A pregnant woman with gravida 3, para 2, living 2 and gestational age of 37 weeks and 3 days was referred to a zonal hospital as previous two lower segment caesarean section (LSCS) term pregnancy with placenta previa for safe confinement with complaints of dry cough. She was admitted with a diagnosis of COVID-19 suspect. During her hospitalization, oxygen (O2) saturation was normal. On investigations her counts were normal. Patient was planned for elective LSCS. COVID-19 test i.e. real time-polymerase chain reaction (RTPCR) report was suspect and asked for repeat sampling. During elective LSCS, delivered single live female baby with intra operative findings of placenta previa with adherent placenta and permpartum hysterectomy was done for same. Uterus with placenta was sent for histopathological examination (HPE). During the surgery her oxygen concentration was normal. Her postoperative recovery was uneventful.


Anaesthesia ◽  
1991 ◽  
Vol 46 (5) ◽  
pp. 404-407 ◽  
Author(s):  
T. N. Trotter ◽  
P. Hayes-Gregson ◽  
S. Robinson ◽  
L. Cole ◽  
S. Coley ◽  
...  

2010 ◽  
Vol 54 (5) ◽  
pp. 409 ◽  
Author(s):  
SeanBrian Yeoh ◽  
SngBan Leong ◽  
AlexSia Tiong Heng

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