Case report

Postpartum Hemorrhage after a Caesarean Section for Placenta Previa Centralis- Conservative Management

Astrit M. Gashi

University Clinical Center of Kosovo, Obstetrician and Gynecological Clinic, Prishtine, Kosovo

Correspondence: Astrit M. Gashi University Clinical Center of Kosovo, Obstetrician and Gynecological Clinic, Pristine, Kosovo 13.K. e Diellit St. “Afrim Zhitia” BLL 3 Hy 1, No.11-1, Pristine 10 000, Kosovo, Tel: +377 44-266 902, E – mail: astritgashi772@gmail.com


Abstract

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 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 light spotting to heavy bleeding that could seriously endanger the woman’s life. In diagnosing of placenta previa helpsymptoms and signs U/S examination is used for diagnosis with up to 95 percent accuracy. 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 maternal and fetal or neonatal mortality rate. We report a case of a 31-year-old woman admitted to our hospital in the department of Obstetrics and Gynecology with signs and symptoms of placenta previa. One day later, the patient gave birth by caesarean section to a healthy baby, but two hours later, the patient’s condition was complicated by postpartum hemorrhage (PPH). The diagnosis was based on symptoms and signs as continuous bleeding ‘ex utero’, clots in vagina, uterine atony, distended bladder, blood loss greater than 1,000 ml, there were signs of a clinically apparent shock. Using a conservative approach such as the application of uterotonic drugs and uterine massage, we managed to save the uterus of the patient.

Keywords: placenta previa, postpartum hemorrhage

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