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Previous LSCSA.BAL

IX SEMSTER

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CASE PRESENTATION

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Mrs.Hajima 26yr old,G4 P3 L1 D2 at 37

weeks+5days POG, housewife, wife of

Mr.Amanullah from Thiruvanamalai with

previous LSCS admitted for altered sugar

profile.

Introduction

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HISTORY OF PRESENT

PREGNANCY

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FIRST TRIMESTER

Spontaneous conception .

Pregnancy was confirmed by UPT at 45 DAYS .

Dating scan was done at 3rd month.

No of antenatal visit= every month

Folic acid was taken

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NO H/O

Bleeding per vaginum.

Excessive vomiting.

Fever with rashes.

Exposure to radiation.

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2nd TRIMESTER Quickening felt at 6th month.

OGTT was done at 6th month.

Found to be abnormal and put on diabetic diet.

Fetal Anomaly scan was done at 7th month.

No of ante natal visit: monthly once

TT was taken at 7th month.

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NO H/O

Scar tenderness

Bleeding per vaginum.

Head ache, Pedal odema, Blurring of vision.

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No. of

pregna

ncy

Date

and

place

of

deliver

y

Duratio

n of

pregna

ncy

Abnor

malties

in

pregna

ncy

Nature

of

labour

Puerpe

rium

Baby

Alive/

stillbor

n

Sex

birth

weight

Present

health

G1 2004 TERM

GH

NIL EMERG

ENCY

LSCS

DUE TO

FAILUR

E OFINDUCT

ION

UNEVE

NTFUL

ALIVE 3.45 kg

female

Healthy

Past obstretic history

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No. of

pregna

ncy

Date

and

place

of

deliver

y

Duratio

n of

pregna

ncy

Abnor

malties

in

pregna

ncy

Nature

of

labour

Puerpe

rium

Baby

Alive/

stillbor

n

Sex

birth

weight

Present

health

G2 2010 TERM

GH

NIL Elective

LSCS

due to

previou

s LSCS

UNEVE

NTFUL

DIED

AFTER

30

MINDU

E TO

MAS

3.25 kg

male

Past obstretic history

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No. of

pregnan

cy

Date

and

place of

delivery

Duratio

n of

pregnan

cy

Abnorm

alties in

pregnan

cy

Nature

of

labour

Puerper

ium

Baby

Alive/

stillborn

Sex

birth

weight

Present

health

G3 March

2012

27

wk+4D

NIL Vaginal

delivery

UNEVE

NTFUL

FETAL

DEMISE

DUE TO

MULTIPLE

FETAL

ANAMO

LIES

800G

Past obstretic history

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Reliable LMP10.10.2012

EDD17.7.2013

Attained menarche at 18 years of age

Menstrual cycle Regular,5/30 day cycle.

2 pads / day.

No h/o passing clots intermenstrual bleeding and

dysmenorrhea

MENSTRUAL HISTORY

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Married 9yrs back.

Non- consanguinous marriage

MARITAL HISTORY

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Not a k/c/o HTN, TB, Asthma, epilepsy, Thyroid

disorder.

PAST HISTORY

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Father is a k/c/o diabetes on medication.

No h/o HTN, TB, Asthma

FAMILY HISTORY

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She is on diabetic diet and insulin.

Normal bowel and bladder habits.

Sleeps for 6-8 hours/day.

No h/o drug allergy.

No addictions.

PERSONAL HISTORY

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EXAMINATION

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Patient is consious, oriented.

HEIGHT:159 cm WEIGHT:76 kg BMI:30.06

VITALS: Pulse- 76/min

BP -110/80 mmHg

RR 16 breaths/min

No Pallor, Pedal edema, Icterus, cyanosis , lymphadenopathy.

THYROID No visible and palpable swelling.

BREAST - Normal

GENERAL EXAMINATION

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SYSTEMIC EXAMINATIONCVS: S1,S2 heard,No murmur.

RS : Normal bilateral vesicular breath sounds.

CNS : No focal neurological deficit.

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Per abdominal examination

INSPECTION:

Longitudinally distended.

Umbilicus- central in position, inverted.

Linea nigra, stria gravidarum present.

Infra umblical vertical scar seen and foundto be healthy

No dilated veins, sinuses.

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PALPATION:

NO SCAR TENDERNESS

Fundal height : 34 wks size

SFH : 33 cm

Fundal grip : Broad , soft , irregular mass felt.

Not independently ballotable.

Lateral grip : Irregular knob like structures felt on rightside.

Smooth ,curved , resistant

structures felt on left side.

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1ST PELVIC GRIP:

Hard, globular mass felt;Independentlyballotable.

2

ND

PELVIC GRIP:NOT Engaged, 5/5th palpable.

AUSCULTATION:FHS- 140/min regular and good tone in

left spino-umbilical line.

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Mrs.Hajima 26yr old,G4 P3 L1 D2 at 37

weeks+5days POG with single live

intrauterine gestation in longitudinal lie,

cephalic presentation , unengaged headwith normal fetal heart sound with 2

previous LSCS , diabetes on insulin and

diabetic diet not in labour.

SUMMARY

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26yr old ,G4 P3 L1 D2 at 37 weeks+5days POG

with 2 previous LSCS with gestation diabetes

mellitus on insulin and diabetic diet.

DIAGNOSIS