Biswas Arati, Bhadra Ashok Kumar, Ganguly Rajendra Prasad, Halder Modhusudan
Department of Obstetrics and Gynaecology, Bankura Sammilani Medical College, Bankura.
J Indian Med Assoc. 2008 Jan;106(1):50-2.
A 22-year-old lady, 3rd gravida presented with discomfort in the lower abdomen and bleeding per vagina following 6 months amenorrhoea. USG of abdomen showed single dead foetus of 21 weeks gestation occupying in the cervical region, endometrial cavity was empty. On laparotomy, cervical region was seen enlarged and distended and over which body of uterus lied. After bilateral internal iliac artery ligation, vertical incision was made over the body of the uterus and cervical region. During the removal of foetal parts and placenta from the cervical region, there was severe haemorrhage for which immediate total hysterectomy was necessitated. In another case, a 28-year-old primigravida was admitted to the hospital with the complaints of abdominal pain at 34 weeks of gestation and she gave history of recurrent pain abdomen throughout pregnancy. USG of abdomen showed a suspected case of secondary abdominal pregnancy. Immediate laparotomy was done and after making a transverse incision over the gestation sac, a live foetus was delivered. A bulky uterus was visible behind the gestation sac and placenta was seen situated,over a part of sigmoid colon and the greatvessels. To see the location of placenta, a part of it got separated spontaneously and severe bleeding started which could not be properly controlled. She received 9 units of blood transfusion but ultimately died. The weight of the baby was 1.9 kg and it had talipes equinovarus. Baby was discharged after 5 days in good condition.
一名22岁女性，第3次妊娠，停经6个月后出现下腹部不适及阴道流血。腹部超声检查显示妊娠21周的单胎死胎位于宫颈区域，宫腔内空虚。剖腹探查时，见宫颈区域增大、扩张，子宫体位于其上。双侧髂内动脉结扎后，在子宫体和宫颈区域做纵切口。在从宫颈区域取出胎儿部分和胎盘时，出现严重出血，因此必须立即行全子宫切除术。另一例，一名28岁初产妇，妊娠34周因腹痛入院，她诉说整个孕期反复出现腹痛。腹部超声检查显示疑似继发性腹腔妊娠。立即行剖腹探查，在妊娠囊上做横切口后，娩出一活胎。在妊娠囊后方可见一个增大的子宫，胎盘位于乙状结肠和大血管的一部分上。为查看胎盘位置，胎盘一部分自行剥离，开始严重出血，无法妥善控制。她接受了9单位输血，但最终死亡。婴儿体重1.9千克，患有马蹄内翻足。婴儿5天后情况良好出院。
