Repeated Medical PG Question- 51

OBSTETRICS AND GYNAECOLOGY (NEET-PG)

Q- A 30 year old woman with complaint of dysmenorrhoea, dyspareunia with chronic pelvic pain undergoes hysterectomy. From the cut section of hysterectomy specimen below identify the condition?

A. Adenomyosis

B. Fibroids

C. Leiomyoma

D. Endometriosis

Answer is A. Adenomyosis

▪️Cross section through the wall of a hysterectomy specimen or a 30 year old woman who reported pelvic pain and abnormal uterine bleeding. The endometrial surfaces is at the top of the image and the serosa at the bottom

▪️Adenomyosis is where the tissue from the lining of womb penetration into the muscle

▪️Adenomyosis can be diffuse or focal the ultimate management of adenomyos is hysterectomy

Q- In atonic PPH which of the following is done?

   a. Uterine massage

   b. Ergometrine is administered to all

  c. B-Lynch is administered to all

   d. Suction of uterus

Options are: 

    A. a and b are true

    B.  b and c are true

   C. a and d are true

   D. b and d are true 

Answer is A. a and b are true

WHO recommended management:-

▪️1st Drug Oxytocin + Uterine Massage & Give Injection Tranexamic Acid.

▪️If bleeding Does not stop then give Methylergometrine.

▪️Carboprost is best drug to prevent & Treat PPH.

▪️Medical Management should be tried for 30 mins.

▪️If it fails Do Mechanical Methods.

Mechanical methods Recommended by WHO-

>Uterine Massage

>Sengstaken Blakemore Esophageal Catheter

>Bakri balloon catheter

>Condom Catheter

▪️Mechanical methods not recommended by WHO-  Uterine Packing

▪️If still it did not work then surgical management should be done