Case 1: In 1990, a 23-year-old woman, married for two years and suffering from primary infertility, was brought before her husband with an ultrasonography of her abdomen and a pelvis report revealing multiple tiny cysts in both ovaries and an infantile uterus; the husband claimed he had been duped into marrying a woman with an infantile uterus and sought a medical divorce. The woman had irregular menstruation prior to marriage due to polycystic ovaries; the husband received a prescription for oral contraceptive pills from a clinician for one cycle to regularise his wife's menstruation; which he continued to administer for two years, oblivious to the fact that oral contraceptive pills suppress endogenous oestrogen, preventing ovulation; Case 2: In 1996, a 25-year-old woman had a lower segment Cesarian section 10 days before her EDC [expected date of child birth], at the request of her husband, who wanted to see the baby before boarding his flight overseas; the lower segment Cesarian section was performed by a urologist, general surgeon, but the mother died on the theatre table, most likely because the woman's expected date of childbirth range would have fallen into the 15 days after expected datum range. Case 3: In 1998, a 27-year-old woman presented with a one-hour postpartum haemorrhage following vaginal delivery of a foeto placental unit; she had a haemoglobin level of 3 gm%; she underwent immediate hysterectomy of the soft uterus, mobilising 10 units of blood; once the bleeding uterus was severed, all 10 units of blood were transfused immediately, and she survived. Case 4: In 1999, a 32-year-old woman was delivering twins breech, she was diagnosed with hepatitis B surface antigen positivity, she had jaundice total bilirubin 3 mg/dl, anemia-haemoglobin of 6.5 gm percent, her twins were managed at higher centres for jaundice during pregnancy; she received 3 units of packed red blood cells during postpartum; she returned for her next pregnancy in the second trimest Case 5: In 2003, a 32-year-old woman presented to emergency with dyspnoea and a 60% desaturation; she was ventilating but her oxygen saturation was low; she had taken hormonal pills for 3 days to postpone her menstruation so she could attend a wedding; she had previously undergone puerperal sterilisation; her electrocardiography showed S1, Q3, T3 changes suggesting pulmonary embolism; thrombolysis, heparinization, intub This person's contraception status increases thrombogenicity by lowering endogenous oestrogen levels as a result of contraception's destruction of germ cells, and her use of hormonal pills to postpone menstruation further lowers endogenous oestrogen levels, increasing her risk of pulmonary thromboembolism. Case 6: In 2014, a 29-year-old woman presented to emergency with 30 minutes of unconsciousness; she had been infertile for 11 years and had delivered a precious baby 34 days prior to admission; she had consumed baby shark food one hour prior to admission due to social ignorance [to enhance mothers milk baby shark food helps]; on examination, she had quadriparesis and was unresponsive. Her MRI brain showed numerous artery constriction with arteriogram and venogram, indicating vasculitis with bilateral asymmetrical, multifocal infarcts. She was given IV immunoglobulin [0.4 gm/kg/day*5 days], requiring ventilatory support, antiedema medications, antiepileptics, and parenteral hydration, and was referred to a higher centre for further treatment. Lifesaving in postpartum haemorrhage following vaginal birth of pregnancy, placenta, emergency hysterectomy with preanesthetic panel workup, blood transfusions, provided after ligation of uterine vessels, severing the soft uterus .
Author(S) DetailsS. Elizabeth Jeya Vardhini
Department of General Medicine, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
. Darmalingam
Department of General Medicine, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
Celestine Raj Manohar
Department of General Medicine, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
. Veerakesari
Department of General Medicine, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
. Maharani
Department of Obstetrics and Gynaecology, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
. Prema
Department of Obstetrics and Gynaecology, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
Sudanthira Devi
Department of Obstetrics and Gynaecology, Karpagam Faculty of Medical Sciences and Research, University of Madras, Tamil Nadu, India.
View Book:- https://stm.bookpi.org/NHMMR-V3/article/view/6341
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