Management of retained placenta and uterus septum after vaginal delivery: case report
Message:
Article Type:
Case Report (دارای رتبه معتبر)
Abstract:
Background

Approximately 3% to 5% of obstetric patients will experience postpartum hemorrhage (PPH). Even though the most common reason for postpartum hemorrhage, as the main cause of maternal death, is uterine atony; other complications such as laceration, hematoma, inversion, rupture; retained tissue or invasive placenta; and coagulopathy may result in PPH. The main cause of retained placenta can be traced to the history of manual placenta removal, violent and numerous curettages, uterus anatomical abnormalities, placenta accreta or placenta previa, and history of cesarean section. Here, we have presented a case of retained placenta and uterus septum.

Case Presentation

The patient, a 36 years old female, multigravid 11 live 3 ,death 1 and abortion 6, with a history of four normal vaginal deliveries, and history of preterm premature rupture of membrane since the 16th week of pregnancy, was admitted to Imam Reza hospital, Mashhad University of Medical Sciences due to labor pain in 29th week of pregnancy. After a vaginal delivery, she was transferred to the operating room due to a retained placenta. During the initial diagnosis, the patient’s cervix was dilated and manual placental removal was not possible. The ultrasound results showed an 80mm heterogeneous tissue in the fundus, extending to the left cornu. There was no sign of accreta. During hysterotomy, the retained placenta was removed from underneath a thick layer of Uterine Septum, using sponge forceps. Five days later, the patient returned with severe pelvic pain and signs of peritonitis. Laparotomy and hysterectomy were performed on account of uterine incision necrosis.

Conclusion

The most crucial step in the treatment of retained placenta lies in the early detection of its cause. The treatment includes manual or Surgical removed of placenta which can result in bleeding, infection, and a lengthy recovery.

Language:
Persian
Published:
Tehran University Medical Journal, Volume:78 Issue: 7, 2020
Pages:
461 to 465
magiran.com/p2182251  
دانلود و مطالعه متن این مقاله با یکی از روشهای زیر امکان پذیر است:
اشتراک شخصی
با عضویت و پرداخت آنلاین حق اشتراک یک‌ساله به مبلغ 990,000ريال می‌توانید 70 عنوان مطلب دانلود کنید!
اشتراک سازمانی
به کتابخانه دانشگاه یا محل کار خود پیشنهاد کنید تا اشتراک سازمانی این پایگاه را برای دسترسی نامحدود همه کاربران به متن مطالب تهیه نمایند!
توجه!
  • حق عضویت دریافتی صرف حمایت از نشریات عضو و نگهداری، تکمیل و توسعه مگیران می‌شود.
  • پرداخت حق اشتراک و دانلود مقالات اجازه بازنشر آن در سایر رسانه‌های چاپی و دیجیتال را به کاربر نمی‌دهد.
دسترسی سراسری کاربران دانشگاه پیام نور!
اعضای هیئت علمی و دانشجویان دانشگاه پیام نور در سراسر کشور، در صورت ثبت نام با ایمیل دانشگاهی، تا پایان فروردین ماه 1403 به مقالات سایت دسترسی خواهند داشت!
In order to view content subscription is required

Personal subscription
Subscribe magiran.com for 50 € euros via PayPal and download 70 articles during a year.
Organization subscription
Please contact us to subscribe your university or library for unlimited access!