22 feb. 2011 POSTPARTUM HEMORRHAGE POST PLACENTA PREVIA CENTRALIS-CONSERVATIVE MANAGEMENT
Astrit M. Gashi
University Clinical Center of Kosovo, Obstetrician and Gynecological Clinic, Prishtine, Kosovo
Placenta previa is the placement of the placenta in the inferior segment of the uterine cavity. This defective implantation of the placenta is in most cases due to a defective vascularization of the decidua. Multiparity, great mother’s age, previous abortions, previous caesarean section, multiple pregnancy, fetal abnormalities, leiomyoma uteri act., constitute some risk factors that favor the development of placenta previa. In a report to the degree of coverage of the internal orifice of the uterus from placental tissue, placenta previa divided into: placenta previa totalis, placenta previa partialis, placenta previa marginalia and low-lying placenta. The dominant clinical signs are vaginal bleeding, which varies from a spotting to a profuse bleeding that could seriously endanger the woman’s life. In diagnosing of placenta previa helps symptoms and signs U/S examination is used for diagnosis with accuracy up to 95 percent. Placenta previa complications appear on 0.5% of all pregnancies. These complications can be; maternal and fetal. All these complications have an effect on the increase of the maternal and fetal or neonatal mortality rate. We report a case of 31-year-old woman presented in Obstetric and Gynecological clinic with signs and symptoms of placenta previa. One day later, the patient was born by caesarean section a healthy baby, but two hours later, the patient’s condition was complicated from postpartum hemorrhage (PPH). The diagnosis was based on symptom and sign as continuous bleeding ‘ex utero’, clots in vagina, uterine atony, distended bladder, blood loss is approximately >1000 ml, there were signs of a clinically apparent shock. Using a conservative treatment such as the application of uterotonic drugs and uterine massage, we managed to be saved uterus.
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