Retain womb in retained placenta: hysterotomy for retained bilobed placenta in a preterm angular pregnancy
Keywords:
Angular pregnancy, Hysterotomy, Retained placenta, Manual removal of placentaAbstract
Angular pregnancy is a unique condition, which may be associated with both foetal and placental abnormalities, as well as preterm labour and retained placenta. Ultrasound is a useful tool in deciding feasibility of manual removal placenta by ruling out adherent placenta. A twenty five years primipara, five hours following preterm vaginal delivery, at 31 weeks of gestation presented with retained placenta. Uterus was well retracted with minimal bleeding, on trans-abdominal ultrasonography placenta accreta was ruled out. After stabilising, she had hysterotomy and placenta was removed which was bilobed. Neonate had cardiac and renal anomaly and succumbed at the end of one month of life. In young women prime priority is to preserve the uterus, by conservative approach as in our case.Metrics
References
Deckers EA, Stamm CA, Naake VL, Dunn TS, McFee JG. Hysterotomy for retained placenta in a term angular pregnancy: a case report. J Reprod Med. 2000;45(2):153-5.
Burmester AJ. Hour-glass contraction of the uterus, and retained placenta. Lancet. 1844;44(1113):404.
Shekhar S, Verma S, Motey R, Kaushal R. Hysterotomy for retained placenta with imminent uterine rupture in a preterm angular pregnancy. Acta Obstet Gynaecol Scand. 2010;89(12):1615-6.
Mayer RB, Yaman C, Ebner T, Shebl O, Sommergruber M, Hartl J, et al. Ectopic pregnancies with unusual location and an angular pregnancy: report of eight cases. Wien Klin Wochenschr. 2012;124(5-6):193-7.
Kwon JY, Hwang SJ, Shin JE, Yoon WS, Shin JC, Park IY. Two cases of angular pregnancy complicated by preterm labor and placental abruption at mid-pregnancy. J Obstet Gynaecol Res. 2011;37(7):958-62.
Alves JA, Alves NG, Alencar Júnior CA, Feitosa FE, da Silva Costa F. Term angular pregnancy: Successful expectant management. J Obstet Gynaecol Res. 2011;37(6):641-4.
Weeks AD. The retained placenta. Afr Health Sci. 2001;1(1):36-41.
Chhabra S, Dhorey M. Retained placenta continues to be fatal but frequency can be reduced. J Obstet Gynaecol. 2002;22(6):630-3.
Agwu UM, Umeora OU, Ejikeme BN, Egwuatu VE. Retained placenta aspect of clinical management in a tertiary health institution in Nigeria. Niger J Med. 2008;17(2):146-9.
