Monday, October 15, 2007

Maternal Mortality #5

Age: 19
Date of death: Hospital Day #2
EDD: Post-delivery (abortion at 4 months induced 4 weeks prior)
Death d uring delivery: No
Clinical diagnosis:

  • Arrives complaining of lower abdominal pains following induced abortion four weeks prior (cassava stem inserted vaginally)
  • Second pregnancy, first child is alive
  • Feverish, vomiting, moderate pallor, no jaundice, fully conscious but weak, in shock
  • Foul-smelling discharge
  • Impression: post-abortion sepsis
  • Peritonitis secondary to septic abortion
  • Find perforated uterus
  • Declines quickly following surgery
Interventions:

  • IV antibiotics
  • IV fluids
  • Exploratory laparotomy and total hysterectomy
  • Taken to ICU following surgery
  • Oxygen

Cause of death: Septic abortion

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