CASE OF SCAR PREGNANCY MISDIAGNOSED FIRST AS INEVITABLE MISCARRIAGE

• Published in: Pakistan journal of science 2023-09, Vol.75 (3), p.621-622
• Main Authors: Fauzia Fatima, Osman, Mardi, Farah, Nadia Sheikh
• Format: Article
• Language: English
• Subjects: Anesthesia; Bleeding; Cervix; Cesarean section; Compression; Consultants; Diagnosis; Hemostasis; Hemostatics; Miscarriage; Misoprostol; Morbidity; Population-based studies; Pregnancy; Pregnancy complications; Pregnant women; Reproductive sterilization; Risk factors; Ultrasonic imaging; Uterus; Vasopressin
• ISSN: 0030-9877; 2411-0930
• DOI: 10.57041/pjs.v75i03.1017

This abstract is about scar pregnancy case which was initially misdiagnosed as a case of inevitable miscarriage. Our patient g3 p1+1 presents in ERE as 7 weeks pregnancy with mild bleeding p/v. she was previous 1 LSCS. After scan and per speculum examination diagnosed as inevitable miscarriage as RPOCS was seen protruding through internal os on speculum examination. Patient was admitted for misoprostol as advised by consultant. Patient did not abort after Misoprostol. Consultant advised for evacuation under general anesthesia. As soon as registrar tried to hold RPPOCS with sponge holder patient started bleeding heavily. Registrar abandoned the procedure and called consultant on call. Consultant first tried to stop bleeding by compression methods but failed, so diagnosis of scar pregnancy with possible perforation was made and laparotomy started and RPOCS removed from scar and uterus closed in layers. Hemostasis secured with difficulty bilateral tubal ligation done, vasopressin given and vertical compression sutures applied. (GTG NO 21 / 2016 NICE clinical guideline 154. Manchester: NICE; 2012). Abdomen closed in layers. In ward 2 units of packed RBCS transfused. Patient discharged in stable condition on second postoperative day.