Spontaneous silent uterine rupture is a life-threatening emergency situation requiring immediate laparotomy. High index of suspicion is key to prevent maternal mortality as at times the presentation can be nonspecific. Authors herein present a case of spontaneous silent uterine rupture during second trimester of pregnancy wherein the diagnosis was initially missed. To the best of authors knowledge, only a few cases with spontaneous fundal second trimester uterine rupture have been recorded so far.
Background:
Pelvic Organ Prolapse (POP) negatively affects the health of a woman in terms of physical, social and emotional wellbeing.
Objective:
The aim of this study was to elucidate the experience of living with prolapse and its impact on daily life.
Methods:
Women undergoing surgery for pelvic organ prolapse were interviewed to evaluate their sociodemographic profile with subsequent impact on their daily life.
Results:
Among the 45 cases with POP, 80% belonged to rural areas. Mean age of study group was 53.68 years. Young age at marriage (mean age 17.31), early first child birth (mean age being 20.5 years) and increased parity (86.66% had parity 3 and above) with majority of children born at home under supervision of untrained dais (77.78%) could probably attribute to their prolapse. Approximately 51% thought that prolapse occurs as a result of hard manual work and 64% cases considered it non treatable. POP was associated with poor quality of life in terms of physical, social and sexual life. Decreased sexual frequency was seen in 86.67% cases. 50% cases reported bladder problems. Sense of incomplete evacuation was seen in nearly 35% and constipation was reported by 37%.
Conclusion:
Though there exists a social stigma associated with pelvic organ prolapse, this study showed that in majority, it was the woman herself who delayed medical help. Health care providers should take initiative in educating women regarding prolapse and to make them aware that it is a treatable condition which can improve their quality of life.
Ectopic or extra-uterine pregnancy occurs most commonly in fallopian tube. High index of suspicion is key to diagnose ectopic pregnancy in a pregnant-women presenting in first trimester with complains of amenorrhoea, pain in lower abdomen and vaginal bleeding. Such pregnancy can be managed by expectant, medically with methotrexate or surgically via laparoscopy or laparotomy if diagnosed promptly. In this case study, a 36-years-old, G2P1+0 presented in second trimester of pregnancy with pain in lower abdomen and vaginal bleeding. Her vitals were unstable and abdomen tender on palpation. Urgent ultrasound was done suggestive empty uterine cavity, a live 13 weeks 6 days fetus in left adnexa and hemoperitoneum suggestive ruptured tubal ectopic pregnancy. The patient’s final diagnosis was live 13 weeks 6 days ruptured left tubal ectopic pregnancy which was managed by emergency laparotomy with a salpingectomy.
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