June 04, 2013
Mrs XYZ
Age:25yrs
H/O of P1L1 with previous LSCS 3months back, came to us with bleeding per vagina on and off since last child birth and increased in severity since last 3-4 days
USG DONE :4/06/2013
INTRA-OPERATIVE FINDINGS
1.Old ,calcified, ?retained product of conception attached to posterior wall of uterus firmly : All the products removed hysteroscopically with hysteroscopic scissor
2.With bits of product over fundus : Removed hysteroscopically with hysteroscopic forceps
Patient withstood the surgery well and sample sent to HPE
PRACTICAL POINTS
1.Definition between old retained products and endometrium not clear – needs to be dissected out
2.Blind curettage in such cases may likely lead to
- a) Incomplete curettage
- b) Push the product further into endometrium
3.Visual documentation and proof achieved with hysteroscopy
