Case report of a patient presenting with metrorrhagia due to retained pieces of fetal bone.
A patient named Saira Bano age--45 years Wife of--Muhammad Abdullah of Jagdishpur, Champaran, Hazaribagh presented in OPD of RAJENDRA INSTITUTE OF MEDICAL SCIENCES, Ranchi on 07.05.2012 with complain of heavy & irregular bleeding per vaginum for 6 months. Her Last menstrual period was on 27th April. Her cycles were 7-8 days/10 [+ or -] 5-7 days. Bleeding is heavy with passage of clots. Her Obstetrical history--Para--6+2, All full term normal delivery at home. Last one was Medical termination of pregnancy of 4 months--6 yrs back by untrained person.
General Examination--Patient was moderately pale. Her pulse was 100/min & Blood pressure--124/70 mm of Hg. Chest--Bilateral vesicular breath sound heard & C.V.S.--Tachycardia was present.
Per Abdominal Examination--Abdomen soft. No tenderness.
Per speculum examination--Cervix unhealthy congested infected discharge present.
Per vaginal Examination--Uterus was retroverted. Slightly bulky Mobility restricted. Fornices free.
Patient was admitted for further investigation. Her Haemoglobin was 8 gm% Total count & Differential count of W.B.C, Routine examination of urine, bleeding time & Clotting time, Blood glucose F & P/P Blood urea & Serum Creatinine all were within normal limits. She was HIV and Hepatitis B surface antigen--Negative, Her Chest X ray & E.C.G. was normal. Patient's Hb was built up by I.V. Iron sucrose + protein diet & vitamin + micronutrients.
U.S.G.--Report showed Endometrium is thick & echogenic--looks like old organized missed products.
Patient was posted for hysterectomy & Total Abdominal Hysterectomy with Bilateral Salpingo oophorectomy was done.
After hysterectomy on cutting open the uterine cavity two pieces of fetal bones were found. Bones were flat & probably scalp bones.
Patient post operative period was un-eventful & was discharged on 8th post operative day.
(1.) Carlso Karen J MD, Eisenstat, Stephonic A MD, Ziporyn, Terra PHD. The new Havard Guide to women health, Havard University.
(2.) Dubinsky TJ-Value of Sonography in diagnosis of abdominal uterine bleeding J. Clin ultrasound-2004; 32-348-353.
(3.) Bignardi T, Van Den Bosch T, Condus G-Abdominal uterine & post menopausal bleeding in the acute Gyanecology unit-Best practice-Clin Obst & Gynae- 2009;23-595-607.
[1.] Bratati Moitra
PARTICULARS OF CONTRIBUTORS:
[1.] Assistant Professor, Department of Gynaecology & Obstetrics, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand.
NAME ADRRESS EMAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Bratati Moitra, 24, Bardwan Compound, P.O.--Lalpur, Ranchi.
Date of Submission: 31/07/2013.
Date of Peer Review: 01/08/2013.
Date of Acceptance: 05/08/2013.
Date of Publishing: 14/08/2013.
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|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Article Type:||Clinical report|
|Date:||Aug 19, 2013|
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