Patient Name: Mrs.

ABC Entitled in POF Hospital G6P4+1 Date of Admission: 8th August 2012 Mode of Admission: Emergency LMP=16th May 2012 EDD=23rd Feb 2013 GA=12weeks GA 12 k

Pain lower abdomen /24hrs Vaginal spotting /24hrs

Planned pregnancy Conceived spontaneously Confirmed on urine for pregnancy test

Four alive & healthy FTPs(Full Term Pregnancy) via SVDs(Spontaneous Vaginal i l Deliveries) li i ) Right salpingectomy- 4yrs back

Complained of generalized, colicky lower abdominal pain NO nausea, vomiting and headache NO aggravating gg g / relieving g factors Vaginal blood: small in amount & dark in color

Vitals:
B.P:100/70mmHg Pulse: 92bpm p Temperature: Afebrile

General physical examination: Unremarkable P/A

Abdomen soft and tender

P/v(Vaginal ( g Examination) )
Cervical tenderness ++ on excitation Adenexal tenderness & fullness ++ Uterus: Normal size, Anteverted & Mobile P/v bleeding +

TAS(T TAS(Trans-Abdominal Abd i lS Scan) ) Investigations

Right cornual ectopic Blood for grouping & cross match Blood CP (Urgent)
Hb=7.8g/dl Hb=7 8g/dl Hct=25 Platelets =150 X 103/mm3

Coagulation profile: with in normal limits 2 PINT of blood arranged

LAPROTOMY WAS PLANNED

Abdomen contained Blood clots Uterus Normal Size Normal Fallopian Right ruptured cornual ectopic Cornual resection Done Mass Clamped & Cut Drain Placed in POD (pouch of Douglus) Secure Hemostasis Uterus conserved

NPO for 24hrs Vital Monitoring: input, output record I/V antibiotics Catheter retained for 24hrs 2 pint of RCC Transfused

Orally allowed Mobilization Drain: < 30ml Catheter and Drain REMOVED

Patient Stable Uneventful recovery Discharge

Patient Name: Mrs. XYZ Entitled in POF Hospital G2P1 Date of Admission: 10th Sept 2011 Mode of Admission: Emergency LMP=2nd April 2011 EDD=19th Jan 2012 GA=23weeks GA 23 k

Pain epigastrium: 1hr Dizziness: 1 hr

Regular booked patient Anomaly scan-shows 21week normal viable pregnancy

Sever epigestric pain Refer to shoulder tip 2 episodes of short lived fainting attacks

Vit l Vitals:

General physical examination: P/A

Pallor ++ Rapid & Shallow respiration

B.P:90/60mmHg Pulse: 102bpm weak & thready Temperature: T t Af b il Afebrile

P/v(Vaginal Examination)
NOT DONE

Tender FH(Fundal Height): 22weeks Gurading & rebound tenderness +

TAS(T TAS(Trans-Abdominal Abd i l Scan) S )

Investigations

Abdominal cavity full of clots FCA: NEGATIVE Fetus lying outside the Uetrus Blood for grouping & cross match Blood CP (Urgent)
Hb=5.5g/dl Hct=20 Platelets =141 X 103/mm3

Coagulation profile: with in normal limits 4 PINT of blood Arranged

EMERGENCY EMERGENCY LAPROTOMY WAS PLANNED PLANNED

Abdomen Full Abd F ll Of Fresh F h And A d Clotted Cl tt d Blood Bl d Dead Fetus lying in abdominal cavity Placenta attached to Right cornu of Uterus Rent of 5.5cm extending to uterine fundus with jagged margins Per operatively prepartumhysterectomy Per-operatively consent was taken All uterine support clamped, cut and ligated Subtotal hysterectomy was done Drain Placed in POD (pouch of Douglus) Cut section of uterus revealed intact edometrium

NPO for 24hrs Vital Monitoring: input, output record I/V antibiotics Catheter retained for 24hrs 3 pint of RCC Transfused

Orally allowed Mobilization Drain: < 50ml Catheter and Drain REMOVED

Patient discharged with smooth Recovery