Title: Can The Abruption Be Chronic?
Dr Debkalyan Maji is an alumnus of RG Kar Medical College, Kolkata. He has completed his Post graduation from Armed Forces Medical College, Pune. His area of interest is High risk obstetrics and Gynaecological Endoscopic surgery
Introduction: Abruptio placentae generally presents as a obstetric emergency with poor fetal outcome and significant maternal morbidity and even mortality.
Description: 29 year G2P1L1 at 24 Wk 5 Day period of gestation reported to our hospital with history of loss of fetal movement for last 2 day with abdominal discomfort and low back ache. There was no bleeding per vaginum. On examination, she was conscious alert and coherent. Pulse - 110, BP 116 / 70 mg of HG. Per abdomen examination revealed fundal height of uterus - 32- 34 was, no fetal part palpable, non tender, FHS - absent. USG carried out and confirmed IUFD, with 19 X 13 cm placental thickness, AFI- 1. Her HB - 5.2 gm%. TLC - 16200/mm3, PT - 15/12, APTT -32/28, INR - 1.28. Per vaginal finding - 1.5 cm, 30 % effaced. Delivery was planned, initially labour induction followed by emergency caesarean delivery. Patient was managed successfully in post operative period by multidisciplinary team with blood and blood component. She recovered fully and subsequently discharged from hospital. She was diagnosed as a case of chronic abruption-oligohydramnios sequence.
Conclusion: Chronic abruption- Oligohydramnios sequence is a rare type of clinical condition found during pregnancy. Early recognition and management leads to successful maternal outcome.