RESUMO
Objectives: To determine the frequency of placenta accreta in patients with placenta previa and previous caesarean sections
Place and duration of study: Fatima Memorial Hospital, from 1[st] June 2014 to 31[st] Dec 2014
Patients and Methods: This prospective study was carried out on 60 patients with the diagnosis of placenta previa, the relationship between previous cesarean sections and subsequent development of placenta previa accreta was analysed
Results: The age distribution revealed that 24 [40%] patients were between the age 36-40 years, followed by 11 [18%] pts between 26-30 years, another 11 [18%] between 30-35 years, 8 [13%] patients were between 21-25 years and 6 [10%] patients were >40 years. Parity distribution showed 24 [40%] patients ranged from G[2] -G[3], and 36 [60%] pts ranged from G[4] or more. From a total 60 women with placenta previa, 5 [8.3%] patients had type 1 placenta previa, 19[31.6%] patients type 2 placenta previa, 12 [20%] patients type3 placenta previa, 24 [40%] patients type 4 placenta previa. Among all these pts, 23 [38%] pts were having placenta accreta intra-operatively, 14 [60%] of these pts ended up in cesarean hysterectomy
Conclusion: The incidence of placenta accreta is directly proportional to the number of previous cesarean sections. Patients with previous cesarean section, and antepartum diagnosis of placenta previa, should be considered as high risk for developing placenta accrete
RESUMO
A large solitary multiloculated pelvic cyst in a 40-year-old woman with chronic pelvic pain was diagnosed to be a Multicystic Benign Mesothelioma [MBM] of peritoneum at laparotomy. Operative findings showed dense adhesions between uterus and bladder anteriorly, small intestines and pouch of Douglas posteriorly, a right ovarian cyst cm containing clear serous fluid and two nodular deposits were seen in the pouch of Douglas, small multiple deposits was found over the mesentery of small intestine and parietal peritoneum. Total abdominal hysterectomy with bilateral oophorectomy and infracolic omentectomy was done. During surgery, there was injury to the small intestine hence, resection of 10 inches of small intestine with re-anastomosis was carried out. Postoperative recovery was satisfactory. At 3 years follow-up, patient is symptom-free