Post Cesarean Vaginal Oozz

Yes! it was post cesarean vaginal oozz...

Panicky sitiation...but...

Patient was stable...and we could diagnose it.

No treatment was required.

History

History –
01. 30 year old Unregistered antenatal case came with complains of Pain in abdomen (Labor Pains..)

02. She was registered with some other doctor bur Unregistered with us…

03. Came without any reference letter. Only some investigations record like blood group & HB was there.

04. She gave history of treatment for infertility at different doctor’s clinics since last 10 years…

05. On General Examination – Blood Pressure was within the limit. No Pallor or edema on feet.

06. On Per Abdominal – Full term Pregnancy with vertex presentation with normal fetal heart rate & good uterine contractions…

07. On Per Vaginal Exam – Show Plus Plus… vagina was narrow ,cervix not felt as in normal case.
But finger was able to touch scalp of head ..head was high..

Impression

Impression -

1.Primigravida at Term

2. In Active Phase of Labor

3.Precious child with High Floating head…

Management

Management –
1. Discussed with Relatives

2. Explained the condition …narrow vagina with high head

3. Consent For cesarean taken.

Cesarean was as usual –

Cesarean was as usual –

1.Lower segment cesarean was done under spinal anesthesia.

2.It was un eventful.

Post operative…

Post operative…
1. After cesarean while cleaning the vulva & vagina …it was seen that minimal blackish colored blood ooze was coming…Labia minor was separated & noticed that the root of ooze is from 2’O clock position…

2.Pressure gauze applied for 3 minutes…Ooze stopped

3. Uterus was massaged to see to it’s contracted state….again Ooze started….

4.We immediately called our Surgeon friend Dr…….…….

5.With the help of him we tried to explore the site…

6.Only dark Ooze ..meaning no fresh blood…so we were not panicky…

7.On examination there was no evidence of injury at local site …which was unlikely of course…

8 finger was able to enter at Ooze site…finger diagnosed it ??? as another vaginal opening…Means Ooze was coming through that vaginal very narrow opening …

9.Patient was shifted in to ward.

10 Close watch on basic parameter & per vaginal bleeding was kept..

For Our Study

For Our Study :

1.On tenth day after cesarean

we examined patient in our labor room.

2.Proir proper consent to shoot

SOS photos was taken…

3.And what we concluded was as follows;

i) Vaginal Opening at normal site

was nearly a blind pouch.

ii) Vaginal Opening at 2’O clock was continues with cervix..

iii) Vaginal Opening at 2’O clock position was more roomy than opening at normal centered site…