We received challenging and difficult cases from across the region in very first three months proved beyond doubt the necessity of such unit.

Cases referred were either of two main categories

1. Reffered pre-operatively because they were high risk cases from medical or surgical or both grounds.

2. Reffered post-operatively after complication during difficult surgeries.

We are highlighting few of them.

Second gravida having previous LSCS had undergone second trimester termination before three months presented with complain of pain in abdomen and off and on bleeding P/V

USG – old RPOC in uterus

MRI – Hemoperitoneum in abdomen, incomplete abortion, uterine A-V malformation on whole posterior uterine wall

End Result

Patient having previous 2 LSCS, IVF twin pregnancy, one IUFD operated for central placenta previa outside.

It turned out placenta increta intra operatively. Patient was in shock even after 11 Unit transfusion and was on ionotropic drugs when referred to us.

After investigation and stabilization we operated patient with following findings.

• Bladder was already open with 5 cm rent



• Lower uterine segment was packed with 10 - 15 abgel
• We separated bladder much downwards and procedure of total abdominal obstetric hysterectomy done
• Bladder closed in two layers
• We transfused 14 units of blood components