Abstract
An: 2021, Nr.2, Articol Nr. 9
Title: 

THE MANAGEMENT OF A PACIENT WITH UTERO-PLACENTAR APOPLEXY – A CASE REPORT

Authors: 

      Ana Maria Haliciu - University of Medicine and Pharmacy „Gr.T. Popa”, Iaşi, Faculty of Medicin, Department of Anatomy; „Elena Doamna” Maternity, Iaşi
      Alina-Georgiana Corduneanu - „Elena Doamna” Maternity, Iaşi
      Simona Vicoleanu Partene - University of Medicine and Pharmacy „Gr.T. Popa”, Iaşi, Faculty of Medicin, Department of Anatomy
      Roxana Mihaela Corduneanu - „Cuza Vodă” Maternity, Iaşi
      Ştefana Raluca Bran - University of Medicine and Pharmacy „Gr.T. Popa”, Iaşi, Faculty of Medicin, Student
      Ioana Pavaleanu - University of Medicine and Pharmacy „Gr.T. Popa”, Iaşi, Faculty of Medicin, Mother and Child Health Department; „Elena Doamna” Maternity, Iaşi
      THE MANAGEMENT OF A PACIENT WITH UTERO-PLACENTAR APOPLEXY: A CASE REPORT (Abstract): Abruptio placentae or placental abruption is defined as the detachment of a normally inserted placenta after the first 20 weeks of pregnancy or during labor, which consequentially causes a placental hematoma with variable clinical manifestations, depending of the degree of the separation. We present a case of a 19 years old pregnant patient, with 36 gestational weeks, followed-up by her ob-gyn from 10 weeks of gestation. She was diagnosed with essential hypertension at the age of 15, with dietary treatment. The patient underwent an emergency C-section diagnosed with: primigravida primiparous 36 weeks of gestation, severe fetal distress, untreated chronic hypertension, secondary anemia. Emergency C-section was performed under general anesthesia with oro-tracheal intubation, from which a male exitus fetus was extracted, weighting 3140 grams. During the surgery, no pathological aspects of the uterus were identified, and normal contractility and hemostasis were achieved. 40 minutes after the surgical intervention, the patient complained of severe bleeding, which led to a secondary emergency surgery. During this reintervention, the following aspects were found: enlarged, atonic uterus, with multiple petechiae, and a hematoma localized between the bladder and the uterus. Interadnexal subtotal hysterectomy was performed. The prognosis in this type of cases is poorer due to hemorrhagic shock and severe anemia, with a subsequent risk of neurological sequelae.
Key words: PLACENTAL ABRUPTION, POSTPARTUM HEMORRHAGE, INTRAPARTUM DEATH, EMERGENCY C-SECTION
Full text
archive
Current edition
2022
Previous editions