Obs & Gynaecology


        

Case Discussion

INTRESTING CASE OF MISSED ABORTION   Posted By Dr.Shweta Agarwal    Date : 04-Oct-03   04:36 AM     Reply

AN INTRESTING CASE OF MISSED ABORTION

CASE SUMMARY

A 20 year old adivasi lady presented with complaint of ammennorrhea 6 months ,bleeding p/v last 1½ months,history of D & C 1½ months back with history of low grade fever and no history of passing any products of conception.Her LMP was not known and according to her, past cycles were regular. On examination patient was anaemic and was febrile,per abdomen uterus was 14-16 wks size firm, on P/S examination bleeding thruough os was present without any foul smell.On P/V os was found closed.

Ultrasonography revealed an single intrauterine foetus of 13.2 wks with no cardiac activity ? intrauterine death..

Under general anaesthesia UCL came out to be 4 inches and nothing was obtained on curettage of uterine cavity .A firm hard mass was felt arising from uterus on right side.Keeping the differential diagnosis of 1] pregnancy in rudimentory horn, 2}extrauterine pregnancy, 3}intrauterine badly adherent missed abortion,the procedure was abondoned and laprotomy was planned,but as the attendants refused consent patient was discharged on request. 4 months later patient arrived in OPD with history of ammennorrhea since time of D & C with uterus 16 wks size soft and a palpable mass in right side of uterus.

USG revealed single intrauterine live foetus of 15.1 wk along with an ectopic macerated foetus measuring 58 x 55 mm possibly in peritoneal cavity or right tube.

To conclude the reabsorbtion of dead macerated foetus along with restoration of fertility by means of reconception was an interesting example of body’s immense capability to regain its anatomy and physiology .

CONTRIBUTED BY Dr.SHWETA AGARWAL {CONSULTANT GYNECOLOGIST}R.K.HOSPITAl





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