Dr. Arun Nayak is Professor and
Head of Department, LTMMC,
Sion, Mumbai, India. He is senior Consultant Gynaecologist,
Obstetrician and Laparoscopic
Surgeon attached to LTM General Hospital, Surya and Cloud 9
Hospital. He is Past President of
Mumbai Obstetrics and Gynaecology Society (MOGS), Secretary of AMOGS and Joint Assistant Editor of JOGI. His main
area of interest is Laparoscopic
and Urinary Incontinence surgeries for which he has received
special training during his Overseas Fellowship at Chungnam University, Korea and has performed
more than 300 surgeries including the TVT and TVT(O) procedures.
He has been awarded with several Prestigious Prizes, Fellowships,
Awards and Medals at the State, National and International levels
including FOGSI Corion Award, MOGS Young Scientist Award and
Hargobind Medical Foundation Overseas Travelling Fellowship.
We report a case of 23-year old female, G2P1NND1 with previous 1 LSCS, 30.2 weeks presented with gross blackish discolouration of skin in lower abdomen and pain in abdomen. Clinical diagnosis was placenta percreta reaching upto anterior abdominal wall (Fig. 1). Ultrasonography showed hyperechoic lesion with fat content in left paramedian infraumbilical region. MRI confrmed focal herniation of the placenta at the site of LSCS scar reaching upto anterior abdominal wall (Fig. 2). Intraarterial balloon infation of uterine arteries was done followed by Laparotomy. Intraoperatively, placental tissue was seen adherent to anterior abdominal wall and dome of the bladder (Fig. 3). Baby was delivered by Classical Caesarean Section and immediately afterwards, partial separation of placental tissue was noted (Fig. 4).Within a span of 10 min, almost 3 L of blood loss occurred and hence Total Obstetric Hysterectomy was performed and both the ovaries were preserved. Patient was transfused with 5 PRC and 5 FFP. Post-operative period was uneventful and patient was discharged after 15 days. On follow-up visit, there was signifcant reduction of blackish discolouration of skin without any other complications (Fig. 5).
Acknowledgements Department of Obstetrics and Gynaecology, Lokmanya Tilak Medical College, Mumbai, India.
Funding None.
Conflict of Interest Nil.
Informed Consent Informed consent was taken in local language
