Uterine laceration – a rare case of postpartum hemoperitoneum

2021 ◽  
Vol 86 (5) ◽  
pp. 335-338
Author(s):  
Carlos Silva Macedo ◽  
◽  
Cristina Pestana Domingos ◽  
Rita Leiria Gomes ◽  
Zeferino Pina ◽  
...  

Postpartum haemorrhage is a major cause of maternal morbidity and mortality worldwide. Early dia gnosis and treatment are essential to prevent sequelae or even death. We describe a rare case of early postpartum haemorrhage with hemoperitoneum due to a laceration of the uterine serosa with exposure of a uterine vessel solved by laparotomy. Key words: postpartum haemorrhage – uterine rupture – parturition

2016 ◽  
Vol 54 (202) ◽  
pp. 88-90
Author(s):  
Pratiksha Gupta ◽  
Anju Huria ◽  
Dilpreet Kaur ◽  
Reeti Mehra

Caesarean scar pregnancy is one of the rarest forms of ectopic pregnancy. Transvaginal ultrasound and color flow Doppler provides a high diagnostic accuracy. A delay in diagnosis and treatment can lead to uterine rupture, major hemorrhage, hysterectomy and serious maternal morbidity and mortality. Early diagnosis can offer treatment options of avoiding uterine rupture and hemorrhage, thus preserving the uterus and future fertility. Primary health care provider should know about this rare entity, because if diagnosed timely, and referral to specialized centre is done without delay will definitely save maternal morbidity and mortality. Management plan should be individualized. Termination of pregnancy is the treatment of choice in the first trimester. Expectant treatment has a poor prognosis because of risk of rupture. In this case report we aim to discuss the associated diagnostic dilemma, most appropriate methods of diagnosis and management, with their implications in clinical practice.Keywords: scar pregnancy; caesarian section; methotrexate. | PubMed


Author(s):  
Reena Sharma ◽  
Kapil Malhotra ◽  
Poojan Dogra ◽  
Anil Kumar ◽  
Sushruti Kaushal ◽  
...  

Puerperal uterine inversion is a complication of third stage of labour, which can lead to maternal morbidity and mortality due to haemorrhage shock and infection. Early cases can be managed by manual reposition of uterus but neglected or late cases of uterine inversion are managed by Haultain`s repair. Here we are presenting a case of subacute uterine inversion referred from peripheral hospital managed by Haultain’s technique.


2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Gieta Bhikha-kori ◽  
Marieke Sueters ◽  
Johanna M. Middeldorp

Uterine rupture is a health problem in every country. The diagnosis is not always obvious and fetal and maternal morbidity and mortality can be high.


Author(s):  
Ibrahima S. Balde ◽  
Ousmane Balde ◽  
Ibrahima Stylla ◽  
Alhassane II Sow ◽  
Massa Keita ◽  
...  

Background: The aim of the work was to study post-operative maternal morbidity and mortality after caesarean delivery and laparotomy for uterine failure, to describe the main causes and to analyze the risk factors.Methods: It was a descriptive, comparative and analytical study lasting 2 years with data collection in 2 phases, one of which was a retrospective study lasting one year from July 2018 to June 2019 and the other a prospective study also lasting one year, from July 2019 to June 2020. It concerned all pregnant women who had been caesarized or had had a laparotomy for uterine rupture with complications and those who had not developed any complications. The parameters studied were types of complications, risk factors and maternal mortality. The Chi-square test was used to compare the two populations with a significance level p=0.05.Results: During the study period, 6141 hospitalizations were recorded among which 5682 surgical procedures were performed, i.e. 92.52% of hospitalizations. Caesarean delivery accounted for 90.55% of surgical procedures and laparotomy for uterine rupture for 1.10%. The overall maternal post-operative morbidity rate was 7.60%. Post-operative anemia was by far the most common complication (75.76%) followed by infection (23.46%). The maternal death rate was 0.92% with a ratio of 409.97 maternal deaths per 100,000 live births and more than 2/3 of these deaths were due to caesarean delivery. Anemia and septic shock were the main causes of death. Factors related to this post-operative maternal morbidity were: age greater than or equal to 40 years, multi-parity, illiteracy, emergency obstetric evacuation, low socio-economic level, poor quality of prenatal follow-up and rupture of membranes before admission.Conclusion: In the emergency context concerning majority of our cesarean deliveries and the totality of uterine ruptures predispose the mother to high significant morbidity and mortality.


2013 ◽  
Vol 20 (05) ◽  
pp. 726-730
Author(s):  
CHANDRA MADHUDAR ◽  
AMBREEN GHORI ◽  
FARKHUNDA KHURSHID ◽  
Syed Zulfiquar Ali Shah ◽  
Tarachand Devrajani

objective: To evaluate frequency, maternal morbidity and mortality in patients with uterine rupture at Gynae Unit -II of civilHospital Hyderabad. Study design: Prospective descriptive study. Study setting: Department of Obstetrics and Gynecology, unit-IILiaquat University Hospital Hyderabad Sindh Pakistan; from 1st October 2010 to 31st March 2011. Subjects and methods: All thepatients diagnosed as case of uterine rupture was taken as study subject. Data was collected in a pre-designed porforma. Variableanalyzed were frequency, demographic characters, maternal morbidity and mortality. Results: During the study, 34 patients out of 1400deliveries presented with uterine rupture resulting in a frequency of 2.42%or 1: 41deliveries. 64.7%(22) patients were between 26 to 35years age and 67.64%(23) were multipara.26.47%(9) presented with extension of tears, 17.6%(6) with shock,20.5%(7) with septicemiaand 20.5%(7) with wound infection. Conclusions: Uterine rupture is yet a common obstetrical emergency in our area. The significantmorbidity and mortality deserves our special attention by a collaborative approach. Regular ante natal checkups, careful selection ofpatients for vaginal delivery, vigilantly monitoring during labor with smooth switch over to operative delivery can reduce this drasticobstetrical complication.


2021 ◽  
Vol 6 (2) ◽  
pp. 1-6
Author(s):  
Balde Ibrahima Sory ◽  

The aim of the work was to study post-operative maternal morbidity and mortality after Caesarean delivery and laparotomy for uterine failure, to describe the main causes and to analyze the risk factors.


F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 1514 ◽  
Author(s):  
Marie Pierre Bonnet ◽  
Dan Benhamou

Postpartum Haemorrhage (PPH) is a major cause of maternal morbidity and mortality. Treatment of acquired coagulopathy observed in severe PPH is an important part of PPH management, but is mainly based on literature in trauma patients, and data thus should be interpreted with caution. This review describes recent advances in transfusion strategy and in the use of tranexamic acid and fibrinogen concentrates in women with PPH.


Author(s):  
Shailesh K. Makwana ◽  
Sonal C. Halpati ◽  
Chirag Patel

Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and mortality, and one of the common obstetrical emergencies. Quite commonly, it occurs in patients where PPH is not expected. Management has to be swift and precise according to the steps and the response initiated by the uterine musculature during the management. In our patient, we had a localized multifocal atony of the uterus, at points where the uterine sinuses were bleeding due to atony, and medical management and uterine tamponade failed, with a raised D-dimer level. As the stepwise management failed with uterine devascularisation failing to control PPH, a decision for uterine compression suture (UCS), Cho suture was taken.


Author(s):  
Ramna Banerjee ◽  
Farheen Rahman

Heart diseases in pregnancy have always been a source of major concern for both the patients as well as the caregivers because of the high risk of maternal morbidity and mortality and the need for specialist care by a multidisciplinary team preferably in a tertiary care hospital. Amongst the whole gamut of heart diseases, pulmonary hypertension is associated with high maternal morbidity and mortality (in the order of 20% in some studies) and hence is considered a contraindication for pregnancy. We report a rare case of a lady at 36 weeks gestation in her second pregnancy, with a previous caesarean section, who was incidentally diagnosed with severe pulmonary hypertension (PAP-110 mmHg) during her antenatal check-up in the third trimester of pregnancy and survived without any major complications after being promptly referred to and treated in a multispecialty hospital. Her previous pregnancy was absolutely uneventful and even in this pregnancy she had very mild symptoms as compared to the severity of the disease found on further investigation.


2021 ◽  
Author(s):  
Felicity Agwu Kalu ◽  
Joan Nkechi Chukwurah

Abstract Background Postpartum haemorrhage (PPH) is one of the major complications of childbirth which results in maternal morbidity and mortality especially in low and middle-income countries like Nigeria. Midwives play a vital role in preventing and managing PPH in Nigerian rural communities. The aim of this study is to understand the experiences of midwives in rural maternity care settings in order to provide appropriate support and improve practice. Methods An exploratory qualitative study of a purposive sample of 15 practicing midwives was carried out using semi-structured interviews from November 2018 to February 2019. Data were transcribed verbatim and analyzed using content analysis. Results Four themes were identified; intervention for preventing PPH, approaches to managing PPH, challenges of preventing and managing PPH, and ways of supporting midwives to overcome the challenges of preventing and managing PPH in rural health care settings. Midwives employed various strategies, such as antenatal education, diagnosis, and treatment of anaemia to prevent PPH. Their understanding of the condition as a life-threatening condition enabled the midwives to provide holistic and effective management that sometimes involved multidisciplinary team approach. However, inadequate resources and delay in seeking health care services militate against their efforts. The midwives also identified the need for continuing education and training as means of enhancing their standard of care. Conclusion These midwives in Nigerian rural health care setting engage in preventive practices and active management of PPH though not without barriers, such as inadequate resources. There is need for the midwives in rural areas to have cultural competence, be provided with adequate resources and participate in ongoing education to be more effective.


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