A case of placenta increta in placenta previa: a rare case report

Placenta increta, one type of morbidly adherent placenta, is characterized by entire or partial absence of the decidua basalis, and by the incomplete development of the fibrinoid or Nitabuch’s layer and villi actually invading the myometrium. When the internal os is covered partially or completely by placenta, it is described as a placenta previa. Simultaneously these two complications occurring in a post LSCS scarred uterus is a very rare scenario and anticipated frequently to cause catastrophic obstetric outcome. A 32-years-old woman of second gravida, para 1, with previous history of LSCS 7 years back, with living issue one, admitted in our hospital at 35 weeks 5 days gestation with asymptomatic placenta previa with placenta increta. The case was diagnosed effectively by ultrasonography. Intra-operatively, compression sutures and bilateral uterine artery ligature was tried to control hemorrhage which were failed and a quick decision of caesarean hysterectomy was done. Preserving both ovaries, total hysterectomy was the only option to save the mother in our case. Other options attempting to preserve uterus could have ended up with grave consequences in this case. This was a very rare case of asymptomatic placenta previa with placenta increta in a post LSCS scarred uterus and it was successfully managed by judicious caesarean hysterectomy.

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Semi-mobile rudimentary tissues attached to a congenital intramitral ring in a woman with previous history of embolic stroke: A rare case report

Ultrasound ◽

10.1177/1742271x19855103 ◽

2019 ◽

Vol 27 (3) ◽

pp. 191-195

Author(s):

Maryam Nabati ◽

Homa Parsaee ◽

Alireza Fattahian

Keyword(s):

Case Report ◽

Mitral Valve ◽

Rare Case ◽

Previous History ◽

Left Ventricular ◽

Embolic Stroke ◽

Valve Repair ◽

Congenital Cardiac Anomalies ◽

Rare Case Report ◽

History Of

Isolated congenital mitral ring is a very rare subtype of congenital mitral valve malformation, which accounts for about one-third of congenital cardiac anomalies associated with left ventricular inflow obstruction. A mitral ring may be easily missed unless the disease is suspected. The mitral valve repair should be considered in symptomatic patients with mitral stenosis. We report a rare case of a 43-year-old woman with an intramitral ring who experienced previous embolic stroke with left hemiplegia. However, stroke happened several years ago and it does not completely prove causality.

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A Rare Shape of Placenta; Placenta Bipartite, Bilobata, Dimidiate, Duplex: A Rare Case Report

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v31i2.34220 ◽

2017 ◽

Vol 31 (2) ◽

pp. 101-103

Author(s):

Pratima Rani Biswas ◽

Gautom Kumar Paul ◽

Mina Chowdhury ◽

Md Selim

Keyword(s):

Rare Case ◽

Blood Donors ◽

Previous History ◽

Bed Rest ◽

First Trimester ◽

Lung Maturation ◽

Rare Case Report ◽

History Of ◽

Foetal Movement ◽

Racial Ethnic

Placenta bipartite is a rare variation of placental morphology. The estimated incidence is up to 2-8 % of pregnancy. There is no distinct racial, ethnic or geographical prediction observed. The diagnosis of an anomalous placenta is important for patient management at the time of delivery. Specifically, the bilobed placenta can be associated with first-trimester bleeding, polyhydramnios, abruption, and retained placenta. Careful attention to the cord insertion is also required for optimal fetal management. We report a case of a 24 years multi gravida with previous history of 2 C/S who had regular antenatal checkup and her pregnancy was uneventful till 36 wks. Her early USG at 16 weeks showed low lying placenta little away from the internal os of cervix. She was advised to take complete bed rest, avoid journey and coitus. Couple was warned about pervaginal bleeding, which may occur any time and also advised to ready at least four blood donors. Her 2nd USG scan at 26wks showed placenta bipartite and insertion of cord over the internal os of cervix. Patient was treated conservatively and dose of inj. Oradexon was completed at 32wks for lung maturation. At 36 weeks, patient perceived less foetal movement and then emergency LUCS with BLTL was done. Baby was well and her postpartum period was uneventful.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(2) : 101-103

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The effect of previous obstetric interventions in the outcome of placenta previa

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174993 ◽

2017 ◽

Vol 6 (11) ◽

pp. 4879

Author(s):

Deepti Bhaskaran Nair ◽

Lekshmi Murukesan ◽

Sangeetha Menon

Keyword(s):

Placenta Previa ◽

Health Centre ◽

Control Group ◽

Case Group ◽

Chi Square ◽

Adherent Placenta ◽

Chi Square Test ◽

Scarred Uterus ◽

Associated Risk Factors ◽

Caesarean Hysterectomy

Background: Increase in the incidence of prior caesarean section and other obstetric interventions have contributed to a rise in the number of pregnancies complicated by placenta previa and its associated adverse maternal and perinatal outcome. This study compared the incidence of placenta previa, associated risk factors, placental position, complications and feto-maternal outcome in scarred and unscarred uterus. Objective of present study was to compare the antepartum, intrapartum and postpartum complications in placenta previa between previously scarred uterus and unscarred uterus.Methods: This was a prospective “nested” case control study for a period of 18 months, conducted at SAT Hospital, Medical College, Thiruvananthapuram with diagnosed cases of placenta previa with previously scarred uterus and without a previously scarred uterus. Statistical method used for analysis was chi-square test and students test wherever appropriate. P<0.05 was taken as significant.Results: In this study of 242 patients, there were 134 in the case group and 108 in the control group. The major types of previa were seen in the previously scarred uterus compared to unscarred uterus (55.9% versus 37.9%). Occurrence of recurrent APH (58.9% Vs 41.6%), postpartum haemorrhage (69.4% Vs 48.1%), adherent placenta (5.9% versus 0%) and need for additional operative procedures (66.4% versus 53.7%) including obstetric hysterectomy, need for blood transfusions, postoperative complications (9.7% versus 1.8%), long postoperative hospital stay were all significantly associated with cases of placenta previa in previously scarred uterus.Conclusions: The primary caesarean rate needs to be reduced in order to reduce future pregnancy problems like adherent placenta and caesarean hysterectomy. Such patients need early referral and management in a tertiary health centre with all facilities available for a better maternal and neonatal outcome.

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A RARE CASE REPORT ON MYXOEDEMA COMA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i3.32401 ◽

2021 ◽

pp. 1-3

Author(s):

SHANTHI B ◽

MARY CHANDRIKA A

Keyword(s):

Case Report ◽

Female Patient ◽

Rare Case ◽

Previous History ◽

Altered Mental Status ◽

Electrolyte Imbalance ◽

Rare Case Report ◽

Life Threatening ◽

History Of ◽

Life Threatening Complication

Myxoedema coma is a sporadic life-threatening complication of severe hypothyroidism with high mortality. Altered mental status and hypothermia are the main symptoms of myxoedema coma. Apart from that, hypoxia, bradycardia, hypotension, anemia, and hyponatremia would be present. Few patients present comatose with severe myxoedema. Presenting coma may mislead the diagnosis of this condition. A female patient presented with fever, breathlessness, and disorientation was admitted. First diagnosed to have electrolyte imbalance and treatment was started accordingly. The patient did not show much of an improvement, and it took a day to identify the presence of severe hypothyroidism. Treating hypothyroidism resulted in an advance in the patient condition. Patients’ previous history of hypothyroidism was not informed during admission. It is always tough to diagnose myxoedema coma when the patients’ previous history of hypothyroidism is unknown. Hence, it is still essential to have hypothyroidism in mind while treating patients with comatose. This case has been reported to alert physicians in diagnosing myxoedema coma patients and to proceed with the treatment at the earliest.

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A rare case of high-grade chondroblastic osteosarcoma post-radiotherapy for a right frontal oligodendroglioma

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1033 ◽

2021 ◽

Vol 2 (2) ◽

Author(s):

Sinead Horan ◽

◽

Oscar Breathnach ◽

Liam Grogan ◽

David Fitzpatrick ◽

...

Keyword(s):

Radiation Exposure ◽

Brain Tumour ◽

Radiation Field ◽

Rare Case ◽

Previous History ◽

High Grade ◽

History Of ◽

Rare Malignancy ◽

Chondroblastic Osteosarcoma

This is the fourteenth case of an intracranial and dural-based osteosarcoma in the literature to date. The case involves a forty-year old woman with a previous history of a brain tumour, which was treated with surgery, chemotherapy and radiotherapy six years previously. The hypothesis is that this rare malignancy is secondary to the radiation exposure given the growth of the lesion in the previous radiation field

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Fatal typhoid intestinal perforation in post tubal ligation death with an alleged medical negligence: a rare case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180209 ◽

2018 ◽

Vol 7 (2) ◽

pp. 755

Author(s):

Pankaj Suresh Ghormade ◽

Ajay Narmadaprasad Keoliya

Keyword(s):

Typhoid Fever ◽

Intestinal Perforation ◽

Rare Case ◽

Tubal Ligation ◽

Medical Negligence ◽

Free Perforation ◽

Ileal Perforation ◽

Rare Case Report ◽

History Of ◽

Difficult Challenge

Worldwide tubal sterilization is commonly used procedure for family planning method. Tubal ligation by minilaparotomy under local anaesthesia is most commonly used method of female sterilization in India. The death rate after tubal sterilizations is 72/100000 for all procedures and mainly due to general anaesthesia or vascular injuries. Iatrogenic injury to bowel can occur in minilaparotomy tubal ligations if there are dense adhesions of intestines or history of previous surgery. In the present case of interval post tubal ligation by minilaparotomy, fatal ileal perforation due to typhoid fever was detected on autopsy which was confirmed after complete histological and lab investigations. Atypical complications of typhoid fever were also noted. In developing countries, typhoid fever is the leading cause of non-traumatic free perforation of intestine and its incidence ranges from 0.9% to 39%, with a high mortality rate. This is rare case of an alleged medical negligence after surgery; in which deciding factor was cause of intestinal perforation i.e. iatrogenic or natural and it posed a difficult challenge.

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Delayed bleeding after prophylactic bilateral internal iliac artery balloon occlusion in elective caesarean hysterectomy for the management of placenta accreta

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171448 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1656

Author(s):

Abdul Karim Othman ◽

Noraslawati Razak ◽

Mohd Hanif Che Mat

Keyword(s):

Iliac Artery ◽

Internal Iliac Artery ◽

Placenta Previa ◽

Balloon Occlusion ◽

Morbidly Adherent Placenta ◽

Adherent Placenta ◽

Internal Iliac ◽

Life Threatening ◽

Caesarean Hysterectomy ◽

Placenta Accrete

Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.

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Non-painful severe variant form of eruptive lingual papillitis: A case report and literature review

Dermatology Reports ◽

10.4081/dr.2021.9020 ◽

2021 ◽

Vol 13 (2) ◽

Author(s):

Manal Ahmed Halwani

Keyword(s):

Emergency Department ◽

Case Report ◽

Literature Review ◽

Oral Hygiene ◽

Rare Case ◽

Dorsal Surface ◽

Variant Form ◽

Girl Child ◽

Rare Case Report ◽

History Of

Eruptive lingual papillitis is a common benign disorder manifested by inflammation of fungiform papillae on the dorsolateral surface of the tongue. Several variants of lingual papillitis have been reported since 1997, most or all of them with painful erythematous papules. Here we report a case of 6 years old girl child with non-painful severe variant form of eruptive lingual papillitis presented to the emergency department. The entire dorsal surface of the tongue was surfaced by 2-3mm by multiple erythematous papules and some with a white or yellowish colour. The papules were excessively inflamed, pigmented, aggregated, and crusted. The cause was idiopathic which resolved within ten days. The parent and patient were reassured with advice to practice oral hygiene. This is a rare case report describing non-painful lingual papillitis without a history of any prior episodes.

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PLACENTA PREVIA

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.01.3003 ◽

2009 ◽

Vol 16 (01) ◽

pp. 139-144

Author(s):

ZOONA SAEED ◽

M. Saeed ◽

M. IKRAM ◽

Roohi Saeed ◽

SHAZIA TAZIAN

Keyword(s):

Placenta Previa ◽

Previous History ◽

Average Hospital Stay ◽

Short Term ◽

Average Hospital ◽

Intraoperative Complication ◽

Causative Factors ◽

History Of ◽

Rising Incidence ◽

Post Graduate Institute

Objectives: To analyze the causative factors and short term complications in cases of placenta previa. D e s i g n a ndSettings: A retrospective study carried out in Obstetrics and Gynecology Department of Sheikh Zayed Post Graduate Institute Lahore.P e r i o d : From June 2004 to June 2007.Subject: Fifty patients with placenta previa. M a i n o u t c o m e m e a s u r e s : Age, parity, previouscesarean section, previous history of evacuation/myomectomy, average hospital stay, need for blood transfusions, emergency/electiveLSCS, associated maternal and fetal morbidity and mortality. Results: There were 50 cases of placenta previa over the period of 3 years.Most frequently occurring intra operative complication was postpartum hemorrhage in 19 patients (38%). Highest morbidity was due toanemia which was in 23 patients (46%). Maternal mortality was 2%, while neonatal mortality was 14%. C o n c l u s i o n : Placenta previa is amultifactorial disease. No doubt that the rising incidence of cesarean section is increasing the intraoperative complication associated withthe condition but other risk factors are also important like age, parity, history of evacuation etc.

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