Hysterotomy and Myomectomy for Retained Placenta in a Uterus: A Case Report
Michael Tyodoo Maanongun *
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.
Jude Obotu Ben-Ameh
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.
Joseph Chiahemba Agulebe
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.
Michael Ushakuma Anenga
Department of Obstetrics and Gynaecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Retained placenta is a common complication, especially in mid-trimester miscarriage. However, when it is further complicated by the presence of multiple fibroids negating removal through the vagina route, it becomes a problematic finding necessitating laparotomy for both myomectomy and removal of the placenta. A 36-year-old G3P0+2 who had a miscarriage at 19 weeks 5 days gestation had a retained placenta with failed attempts at both medical and manual removal due to multiple uterine fibroids. She eventually had a hysterotomy and myomectomy with satisfactory results. The intraoperative challenges were removal of very many uterine fibroid seedlings of various sizes including large ones in a gravid uterus leading to an estimated blood loss of 4,500 ml and necessitating the transfusion of a total of eight units of blood. This case highlights one of the several complications of fibroids coexisting with pregnancy and its management.
Keywords: Retained placenta, laparotomy, hysterotomy, myomectomy