Previous LSCS
Transcript of Previous LSCS
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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