Placenta mboliz spectrum (PAS), refers to the range of pathologic adherence of the placenta into the myometrium namely placenta mboliz, increta and percreta. Maternal morbidity and mortality is high because of severe and sometimes life-threatening haemorrhage. We report a case of placenta percreta, where with the help of interventional radiologist, we could save the uterus and decrease the post operative morbidity. A 38 year old female was referred at 24 weeks of gestation for suspected case of placenta percreta. With regular antenatal follow up, she underwent a elective classical caserean section (CS), at 34 weeks of gestation, with bilateral uterine artery embolization, where placenta was left in situ. She remained in close follow up, with clinical examination, ultrasonography (USG), magnetic resonance imaging (MRI) and beta human chorionic gonadotrophin (hCG) levels. Except a few minor post operative complaints patient remained stable. She had to undergo postoperative cystoscopy and methotrexate therapy for haemturia due to invasion of bladder by placenta. She was followed for next 6 months with successful outcome by getting almost complete resorption of placenta and attaining normal menstrual function. With multi disciplinary approach in a case of PAS, we could manage to leave the placenta in situ during CS and consequently, we could overcome the life threatening complications of placenta percreta and bladder morbidities, were able to avoid hysterectomy and a successful postpartum outcome was achieved. Keywords- placenta percreta, uterine artery mbolization, classical caesarean section, methotrexate
Placenta mboliz spectrum (PAS), refers to the range of pathologic adherence of the placenta into the myometrium namely placenta mboliz, increta and percreta. Maternal morbidity and mortality is high because of severe and sometimes life-threatening haemorrhage. We report a case of placenta percreta, where with the help of interventional radiologist, we could save the uterus and decrease the post operative morbidity. A 38 year old female was referred at 24 weeks of gestation for suspected case of placenta percreta. With regular antenatal follow up, she underwent a elective classical caserean section (CS), at 34 weeks of gestation, with bilateral uterine artery embolization, where placenta was left in situ. She remained in close follow up, with clinical examination, ultrasonography (USG), magnetic resonance imaging (MRI) and beta human chorionic gonadotrophin (hCG) levels. Except a few minor post operative complaints patient remained stable. She had to undergo postoperative cystoscopy and methotrexate therapy for haemturia due to invasion of bladder by placenta. She was followed for next 6 months with successful outcome by getting almost complete resorption of placenta and attaining normal menstrual function. With multi disciplinary approach in a case of PAS, we could manage to leave the placenta in situ during CS and consequently, we could overcome the life threatening complications of placenta percreta and bladder morbidities, were able to avoid hysterectomy and a successful postpartum outcome was achieved. Keywords- placenta percreta, uterine artery mbolization, classical caesarean section, methotrexate
Spontaneous hemoperitoneum in pregnancy is a rare and challenging obstetric emergency. It can present as acute abdomen with features of hypovolemic shock and requires high index of suspicion for diagnosis as various obstetric and non-obstetric causes have similar presenting features. Here we present a case of primigravida at 33 weeks of gestation who presented with acute abdomen, signs of shock and a pathological trace on cardiotocogram .She underwent laparotomy and cesarean section in view of suspicion of abruption placentae. Intraoperatively there was hemoperitoneum of 600ml with 750 grams clots and a small venous bleeder on the posterior surface of the uterus which was secured with hemostatic sutures. Patient got discharged along with the baby on seventh postoperative day. Timely intervention is paramount in reducing maternal morbidity and mortality.
Globally incidence of Non Hodgkin’s lymphoma (NHL) is 3% of which 1% occurs in extranodal lymphoma [1]. Among them, diffuse large B-cell lymphoma (DLBCL) is the most common subtype, accounting for 50% of the cases [2]. Plasmablastic lymphoma (PBL) is a rare and aggressive variant of DLBCL with plasmablastic features, commonly occurs in the oral cavity of human immunodeficiency virus (HIV) infected patients. Primary female genital system lymphoma (PFGSL) is a rare disease, accounting for 0.21-1.1% of extranodal lymphoma [2,3]. Here we report a unique rare case of Uterine PBL in an HIV/Epstein-Barr virus-negative patient that was initially diagnosed as endometroid carcinoma.
