•         31y  Female patient delivered one month back came with complaints of P/V bleeding since 4 hours. Soakage of 7-8 pads

•         H/o giddiness

•         O/H : P2 L2

          Both full term normal hospital deliveries.

          Both male children. First child 1 year old. Second child 1 month old.

•         Past, Personal, family H/O ® Not significant.

•         O/E :          G-C fair

                             A febrile

                             P 96/min

                             BP 100/60 mmHg.

                             Pallor  + +

                             S/E RS - NAD

                                    CVS - NAD

•         P/A: Soft.

Bowel sounds - Normal

•         P/S: Vulva Normal

                    Vaginal walls normal.

                   Cx Lips normal.

                   Growth 4× 4cm reddish brown colour protruding

                   through cervix.

                   Highly vascular, bled on touch.

•         P/V: Uterus anteverted, bulky.

          - Cx Soft

          - Fornices free non tender. Growth 4×4cm     

     protruding through cervix was     friable, bled on  

     touch.

          - The probe can be passed from the sides of the

     growth ( rule out puerperal uterine inversion).

          -Thick pedicle felt above the growth

Investigations 

          - Hb 6.4gm%

          - Bl. Group B+ve.

          -USG : Bulky uterus e/o growth in cervix.

Rx:

•         1 Bottle Blood Transfusion given preoperatively.

•         Decision of immediate  Abdominal Hysterectomy taken.

•         Abdominal Hysterectomy done. Post operative 1bottle blood transfusion given.

•         Specimen sent for HPR.

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