You are on page 1of 25

Previous LSCS

A.BAL IX SEMSTER

CASE PRESENTATION

. housewife. wife of Mr.G4 P3 L1 D2 at 37 weeks+5days POG.Introduction • Mrs.Amanullah from Thiruvanamalai with previous LSCS admitted for altered sugar profile.Hajima 26yr old.

HISTORY OF PRESENT PREGNANCY .

• No of antenatal visit= every month • Folic acid was taken . • Dating scan was done at 3rd month. • Pregnancy was confirmed by UPT at 45 DAYS .FIRST TRIMESTER • Spontaneous conception .

. Fever with rashes. Excessive vomiting.• NO H/O Bleeding per vaginum. Exposure to radiation.

• Fetal Anomaly scan was done at 7th month. • No of ante natal visit: monthly once • TT was taken at 7th month. • OGTT was done at 6th month.2nd TRIMESTER • Quickening felt at 6th month. • Found to be abnormal and put on diabetic diet. .

Head ache.• NO H/O Scar tenderness Bleeding per vaginum. Pedal odema. . Blurring of vision.

Headache . Pedal edema. • Growth scan was done at 8th month. • STARTED on insulin NPH for past 2 months and diabetic diet. . spotting. Blurring of vision.Bleeding/ Leaking per vaginum.• Fetal movements perceived adequately. • NO H/O scar tenderness.

45 kg female Healthy . of pregna ncy Date and place of deliver y 2004 Duratio n of pregna ncy Abnor Nature malties of in labour pregna ncy NIL Puerpe rium Baby Alive/ stillbor n Sex birth weight Present health G1 TERM GH EMERG UNEVE ENCY NTFUL LSCS DUE TO FAILUR E OF INDUCT ION ALIVE 3.Past obstretic history No.

25 kg AFTER male 30 MINDU E TO MAS .Past obstretic history No. of pregna ncy Date and place of deliver y 2010 Duratio n of pregna ncy Abnor Nature malties of in labour pregna ncy NIL Puerpe rium Alive/ stillbor n Baby Sex birth weight Present health G2 TERM GH Elective UNEVE LSCS NTFUL due to previou s LSCS DIED 3.

of Date pregnan and cy place of delivery Duratio n of pregnan cy Abnorm Nature alties in of pregnan labour cy Puerper ium Baby Alive/ Sex stillborn birth weight UNEVE NTFUL FETAL 800G DEMISE DUE TO MULTIP LE FETAL ANAMO LIES Present health G3 March 2012 27 wk+4D NIL Vaginal delivery .Past obstretic history No.

2013 • Attained menarche at 18 years of age • Menstrual cycle Regular.2012 • EDD—17.MENSTRUAL HISTORY • Reliable LMP—10.7.5/30 day cycle.10. • 2 pads / day. • No h/o passing clots intermenstrual bleeding and dysmenorrhea .

consanguinous marriage .MARITAL HISTORY • Married 9yrs back. • Non.

Asthma. TB.PAST HISTORY • Not a k/c/o HTN. Thyroid disorder. epilepsy. .

Asthma .FAMILY HISTORY • Father is a k/c/o diabetes on medication. TB. • No h/o HTN.

• Sleeps for 6-8 hours/day. . • No addictions. • Normal bowel and bladder habits.PERSONAL HISTORY • She is on diabetic diet and insulin. • No h/o drug allergy.

EXAMINATION .

Pedal edema. BREAST .GENERAL EXAMINATION • Patient is consious. HEIGHT:159 cm WEIGHT:76 kg BMI:30.Normal . Icterus.06 VITALS: Pulse. THYROID – No visible and palpable swelling.76/min BP -110/80 mmHg RR – 16 breaths/min No Pallor. cyanosis . oriented. lymphadenopathy.

.SYSTEMIC EXAMINATION CVS: S1.No murmur. CNS : No focal neurological deficit. RS : Normal bilateral vesicular breath sounds.S2 heard.

stria gravidarum present. • Umbilicus.Per abdominal examination • INSPECTION: • Longitudinally distended. sinuses. inverted. .central in position. • Linea nigra. • Infra umblical vertical scar seen and found to be healthy • No dilated veins.

Smooth .curved . Lateral grip : Irregular knob like structures felt on rightside. soft . Not independently ballotable.• PALPATION: • NO SCAR TENDERNESS Fundal height : 34 wks size SFH : 33 cm Fundal grip : Broad . irregular mass felt. resistant structures felt on left side. .

2ND PELVIC GRIP: NOT Engaged.• 1ST PELVIC GRIP: Hard. .140/min regular and good tone in left spino-umbilical line. 5/5th palpable. AUSCULTATION: FHS. globular mass felt.Independently ballotable.

.Hajima 26yr old. cephalic presentation . unengaged head with normal fetal heart sound with 2 previous LSCS . diabetes on insulin and diabetic diet not in labour.SUMMARY • Mrs.G4 P3 L1 D2 at 37 weeks+5days POG with single live intrauterine gestation in longitudinal lie.

G4 P3 L1 D2 at 37 weeks+5days POG with 2 previous LSCS with gestation diabetes mellitus on insulin and diabetic diet.DIAGNOSIS • 26yr old . .