OBS AND GYNE CASE PRESENTATION.pptx NEW.pptx

Good 👍

1. Case presentation Obs. And Gyne { group B2 }

2. 40 years old, female patient, G7,P5,+1, from Bani-Matar and lives in Sana'a, has one offspring who is know 12 years old, housewife, married since 13 years ago, no special habits, A- blood group, she was admitted on 21of July -2025 to Al- S abeen hospital, and the history was taken from patient herself.

3. Husband history : 40 years old, farmer, no special habits, no chronic diseases, B+ blood group. Chief complain : 9 months pregnant women came to emergency room complaining of lower abdominal pain after 12 hours of trial of labor.

4. G7, P5-4,+1female patient in 38 weeks as evident by first day of last menstrual period which was in 30/11/2024 so the expected date of delivery is on 7/8/2025. The patient is unknown case of any medical illness, she was quite will until 12 hours prior to admission she started complaining of lower abdominal pain, which was gradual in onset, progressive intermittent in course, sever in nature, colicky in character,

5. consisted of contractions that last for one minute each time , radiated to back and mid thigh, no aggravating or reliving factors, no associated symptoms as vaginal bleeding or discharge, patient was admitted first to health care center in Fag-Attan where they do ultrasound, investigation, and PV examination, then started trial of labor by augmentation with out any benefit,

6. So they pressed fundus of the uterus in an attempt to push the fetus f or many times without any success, so the patient was referred to Al-Sabeen hospital, when she arrived to ER complaining of sudden sever abdominal pain, progressive continuous in course, radiated to back, no aggravating or reliving factor, followed by desire of uterine contraction, no felling of fetal movement, no vaginal bleeding or discharge,

7. t he was exhausted with sever pallor, so ABCD, PV examination and investigations were done then patient referred to OT immediately, in OT under spinal anesthesia with complete aseptic condition Pfannenstiel incision was done in previous CS scar, 2000 cc of blood was gushed, they observe an edematous bladder and a single dead female reserved breech when they open the uterus from lower segment.

8. After removing placenta and membrane they discover a 7cm hematoma in the right upper posterior wall of the uterus with longitudinal rupture in lower posterior segment extended to posterior cervix and 3cm of posterior vaginal wall so they change to general anesthesia, suture layer by layer and put tow drains then patient was referred to ICU.

9. Thank you