Hysterotomy for retained placenta with imminent uterine rupture in a preterm angular pregnancy.

摘要

A 26-year-old primigravida was wheeled into labor ward at 30 weeks in preterm labor. She had no record of her poorly supervised antenatal period. Soon after she was admitted she delivered a preterm asphyxiated female child. Methylergometrine 0.2 mg was administered intramuscularly at delivery of anterior shoulder. An abnormal lateral bulge was noted at uterine fundus after the delivery owing to the skinny body build of the patient. There was no evidence of placental separation even after 30 minutes and a diagnosis of retained placenta was made. Manual removal was attempted in the operation theatre but failed despite all measures as the placenta remained beyond reach and the cervical os did not yield. Even sharp curettage was attempted but it could not reach placental edge and vaginal bleeding became brisk. Lap-arotomy was done.