A case of multiple fibroid uterus, complete placenta praevia, antepartum haemorrhage, myomectomy and obstetric hysterectomy: a near miss

L. Thulasi Devi, Shivani Mahajan, Athul R. S.


An interesting case of young unbooked, unregistered, primigravida with multiple fibroid uterus, placenta praevia type IV, presented with APH in haemorrhagic Shock, impacted large fibroid in Lower Uterine Segment and Multiple fibroids on Anterior wall, fundus for which myomectomy was performed. Preterm Caesarean Section with extremely low birth weight infant delivered followed by life-saving Emergency Obstetric hysterectomy. She had uneventful recovery without any complications of massive transfusion or surgery. Case is being reported as an obstetric near miss.


Multiple fibroids, Impacted fibroid in LUS, APH, Preterm CS, Obstetric hysterectomy

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World Health Organization. Reviewing severe maternal morbidity: Learning from survivors from life threatening complications. Beyond the Numbers: Reviewing Maternal Deaths and Complications to Make Pregnancy Safer, 2004. Available at: Accessed on 26 February 2021.

Pattinson RC, Buchmann E, Mantel G, Schoon M, Rees H. Can enquiries into severe acute maternal morbidity act as a surrogate for maternal death enquiries? BJOG. 2003;110(10):889-93.

Filippi V, Brugha R, Browne E, Gohou V, Bacci A, De Brouwere V, et al. Obstetric audit in resource-poor settings: lessons from a multi-country project auditing 'near miss' obstetrical emergencies. Health Policy Plan. 2004;19(1):57-66.

Liyew EF, Yalew AW, Afework MF, Essén B. Incidence and causes of maternal near-miss in selected hospitals of Addis Ababa, Ethiopia. PLoS One. 2017;12(6):0179013.

Shahid A, Rizwan S, Khawaja N. Near miss events frequency and most common causes. Pak J Med Health Sci. 2015;9(3):920-2.

Khatun T, Rahman Z, Parveen N, Ansari AA, Mansuri MI, Chaurasia AK. Obstetric near miss events in a tertiary research level teaching hospital. Med Phoenix. 2017;2:44-7.

Ngonzi J, Tornes YF, Mukasa PK, Salongo W, Kabakyenga J, Sezalio M, et al. Puerperal sepsis, the leading cause of maternal deaths at a Tertiary University Teaching Hospital in Uganda. BMC Pregnancy Childbirth. 2016;16(1):207.

Buddeberg BS, Aveling W. Puerperal sepsis in the 21st century: progress, new challenges and the situation worldwide. Postgrad Med J. 2015;91(1080):572-8.

Soma-Pillay P, Pattinson RC. Barriers to obstetric care among maternal near misses. S Afr Med J. 2016;106(11):1110-3.

Chhabra P. Maternal near miss: an indicator for maternal health and maternal care. Indian J Community Med. 2014;39(3):132-7.