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WEL COME

WEL COME. PRESENTED BY AMBILY K.M OPERATING ROOM. PLACENTA ACRETA EMERGENCY C/S FOLLOWED BY HYSTERECTOMY. DEMOGRAPHIC DATA.

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WEL COME

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  1. WEL COME

  2. PRESENTED BY AMBILY K.M OPERATING ROOM PLACENTA ACRETA EMERGENCY C/S FOLLOWEDBY HYSTERECTOMY

  3. DEMOGRAPHIC DATA

  4. Name : Mrs.A D M • Age & sex : 47yrs / female • M R No. : 193857 • Date of admission : 05 .01.2013 • G P L A : G9 P7 L7 A1 • Gestationational Age : 30 wks +6 days • Pre- op diagnosis : Placenta acreta • Surgery : Emergency C S Followed by Hystrectomy • Date of surgery : 16.01.2013 • Date of discharge : 19.01.2013

  5. PHYSICAL ASSESSMENT

  6. 1. General Apperance • Patient is 47 yrs old female weighs 88 kg • Concious & oriented • Looks weak & fatigue due to pain  Vital signs of the patient are Bp : 108/62 mm of hg PR : 76/mnt RR : 20/mnt SPO2 : 99%

  7. 2. Skin • Skin is warm • Has edema on legs • Warm with good turgor

  8. 3. Head and Neck • Hair Is Equally distributed • Absence Of Dandruff & alopecia • 4. Eyes • Able to move both eyes.

  9. 5. Ears • Patients pinna is same colour as fascial. • Able to hear sounds clearly . • No discharges. • 6.Nose • Nasal mucosa is pink • Nasal congestion present

  10. 7.Neck And Throat • Lips are pale & dry. • Teeth is propely aligned with no dentures. • No tenderness of node. • No palpable masses or leisions

  11. 8.Thorax • The Thorax Is Symmetric On Inspection. • Dry cough present • Clear breath sounds

  12. 9.Cardio Vascular • E C G is normal • No cardiomegaly • Apical pulse is 76 bpm

  13. 10. Breast • Symmetrically enlarged . • Montgomerys tubercle present. • Nipples darkish in colour.

  14. 11.Abdomen • Flaby abdomen. • Strae gravidarum & linea nigra present. • Classic incision scar & dressing present. • 12 Genito Urinary • With foley catheter fr.16

  15. 13. Gastro Intestinal • No bowel distension present. • 14. Neurologic • Patient Is mentally alert and oriented with circumstances. • Able to follow commands. • No neurovascular deficit.

  16. PATIENT HISTORY

  17. A .Past medical history • She is a known case of hypothyroidism & on Thyroxin 150 mg O D.

  18. B .Past obstretric history • 2 F T N D, 5 L S C S & 1 abortion. • Previous antenatal period was good & C S done due to fetal distress at term.

  19. C.Presentobstrectrichistory

  20. G 9 P 7 L 7 A 1 • gestational age 29+2 WKS • spotting P V & abdominal pain on 05.01.13. • admitted in OB antenatal ward. • U S G diagnosed as a case of placenta acreta & treated. • on 16 .01. 2013-she experienced severe lower abdominal pain & fresh bleeding with clots through vagina.

  21. Emergency c/s followed by hysterectomy was done. • as an emergency and life saving treatment. • A viable male baby (30+6 WKS) extracted • at 0225H • weighing 1.77 kg . • Apgar score was 7/10.

  22. INVESTIGATIONS DONE • FOR THE PATIENT • 1.U SG Abdomen • 2.blood investigations like • CBC • PT-INR • RH TYPING • ELECTROLYTES

  23. LAB INVESTIGATIONS

  24. Anatomy &Physiology Of Uterus

  25. inverted pear-shaped muscular organ. • located between the bladder and rectum. • nourish and house the fertilized egg until offspring. • It is suspended in the pelvis by broad ligaments. • Weight of a normal uterus is 60 to 80 grms.

  26. The uterus consists of :- • body or corpus • Fundus • Cervix • isthmus

  27. Walls of the uterus • The walls are thick and are composed of 3 layers: • the endometrium • the myometrium • the perimetrium

  28. VAGINA • 6 inches long • leading from the uterus to the external genitalia. • located between the bladder and the rectum. • provides the passageway for childbirth and menstrual flow.

  29. Fallopian Tubes (Two) • each tube is about 4 inches long. • transport ovum from the ovaries to the uterus. • no contact of fallopian tubes with the ovaries. • The distal end of each fallopian tube has finger-like projections called fimbriae. • most desirable place for fertilization is the fallopian tube.

  30. OVARIES • Functions are for oogenesis and hormone production. • ovaries are about the size and shape of almonds. • lie against the lateral walls of the pelvis, one on each side. • They are enclosed and held in place by the broad ligament.

  31. THE LIGAMENTS OF THE UTERUS

  32. UTERINE ARTERY

  33. TOPIC PRESENTATION

  34. PLACENTA ACCRETA Placenta accreta is a potentially life threatening obstetric condition in which the placenta is abnormally attached to the uterus. This can lead to massive blood loss during or following delivery.

  35. TYPES OF ABNORMAL PLACENTALIMPLANTATIONS

  36. The risks of placentaaccreta to the baby

  37. The risks of placenta accreta to the mother

  38. Complications

  39. Treatment of placentaacreta

  40. Effectively there are three treatment options:-

  41. Hysterectomy A hysterectomy is the surgical removal of all or part of the uterus, or womb. The doctor may also remove the fallopian tubes, ovaries and/or the cervix during the same surgery

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