An Atypical Presentation of Late Postpartum Hemorrhage: A Case Report
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Dosyalar
Tarih
2008
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu vaka sunumunda literatürde benzerine rastlamadığımız bir geç postpartum siklik uterin kanama olgusu sunulmuştur. 21 yaşındaki hasta kliniğimize aşırı vajinal kanama şikayeti ile başvurdu. Hastanın 40 gün önce bir dış merkezde sezaryen ile doğum yaptığı öğrenildi. Pelvik muayenesinde aktif vajinal kanaması vardı. Uterus involusyonunun tamamlanmış idi. Ultra-sonografide uterus normaldi ve uterin kavitede rest plasenta ile uyumlu görüntü saptanmadı. Laboratuar incelemesinde hemoglobin: 7.2 gr/dl, diğer değerler normal idi. Hastaya oksito-sin infüzyonu, methylergobasine maleate ve antibiyotik tedavisi başlandı. Kan transfüzyonu yapıldı. Kanaması azalan hasta kontrole gelmek üzere taburcu edildi. Hasta 1 ay aralarla iki kez daha benzer tablolarla kliniğimize başvurdu. Laparatomi yapılması planlandı. Yapılan operasyonda insizyon hattı bisturi ile açıldı. Kavite içerisinde hemoraji mevcuttu. Keşi hattının sağ köşesinde aktif olarak kanayan damar ağızları ve komşuluğunda yaklaşık 2x2 cm'lik amnion zarına ait rest izlendi. Rest çıkarılarak aktif kanayan damarlar sütüre edildi. Hastanın postoperatif dönemde yapılan 3 günlük takibinde vajinal kanamasının olmaması üzerine taburcu edildi.
In this case report, late postpartum cyclic uterine bleeding is demonstrated and is unique in literature with its clinical course. A 21 year old patient admitted with massive vaginal bleeding. It was learnt that the patient had cesarean delivery 40 days ago. In pelvic examination there was active vaginal bleeding. The uterine involution was completed. In ultrasonography uterus was normal and there was not any placental rest in uterine cavity. In laboratory; hemoglobin was 7.2gr/dl, other values were normal. Oxytocin infusion, methylergobasine maleate and antibiotic were administered. Blood transfusion was done. Patient was discharged after follow-up. Patient admitted twice again with same symptoms with 1 month intervals. Laparotomy was planned. During laparotomy, uterine incision site was opened. Hemorrhage was present within endometrial cavity. There were vessels bleeding on the right side of incision and 2x2 cm sized rest of amniotic membrane. The rested tissue was extirpated and vessels were sutured. The patient was discharged after 3 days of follow-up.
In this case report, late postpartum cyclic uterine bleeding is demonstrated and is unique in literature with its clinical course. A 21 year old patient admitted with massive vaginal bleeding. It was learnt that the patient had cesarean delivery 40 days ago. In pelvic examination there was active vaginal bleeding. The uterine involution was completed. In ultrasonography uterus was normal and there was not any placental rest in uterine cavity. In laboratory; hemoglobin was 7.2gr/dl, other values were normal. Oxytocin infusion, methylergobasine maleate and antibiotic were administered. Blood transfusion was done. Patient was discharged after follow-up. Patient admitted twice again with same symptoms with 1 month intervals. Laparotomy was planned. During laparotomy, uterine incision site was opened. Hemorrhage was present within endometrial cavity. There were vessels bleeding on the right side of incision and 2x2 cm sized rest of amniotic membrane. The rested tissue was extirpated and vessels were sutured. The patient was discharged after 3 days of follow-up.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Late cyclic postpartum hemorrhage, Placental rest, Laparotomy, Geç postpartum siklik kanama, Rest plasenta, Laparatomi
Kaynak
GORM:Gynecology Obstetrics & Reproductive Medicine
WoS Q Değeri
Scopus Q Değeri
Cilt
14
Sayı
2
Künye
Balcı, O., Karataylı, R., Acar, A., (2008). An Atypical Presentation of Late Postpartum Hemorrhage: A Case Report. GORM:Gynecology Obstetrics & Reproductive Medicine, 14(2), 125-126.
