An Unusual Complication at

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An Unusual Complication at Medical
Termination of Pregnancy (M.T.P.)
(14 feet of intestinal injury)
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Presented By Dr.Narayan M.Patel M.D.,D.G.O.
FICS Mahalaxmi Institute of medical teaching, 3,
Shantiniketan park, Naranpura, Nr.Sardar Patel
Colony, AHMEDABAD- 380 014 (Gujarat)
INDIA T.N.[phone], E mail-
narayanpatel1932_at_yahoo.com
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M.T.P. was attempted by an unqualified general
practitioner, to terminate 16 weeks of
pregnancy, in a middle-aged patient, in the city
of Ahmedabad (Gujarat state) INDIA
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Not knowing what he is pulling out, ultimately
got frightened, and he came with the patient to a
general hospital at 10 oclock night.
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Patient was resuscitated. Gynecologist asked
help from surgical team. Laparotomy was
performed.
This slide shows loops of intestine coming out
of vulva and lying in a kidney tray, in
operation theater Pt. was in a state of shock.
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Patient was in a state of shock
Same as previous slide, at a little close up
view. Loops of intestine are in kidney tray.
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Patient was in shock with about 8 to 10 feet of
intestine hanging out of vagina, on admission.
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Gynecologist performed laparotomy immediatey and
help from surgical team was asked for. At
laparotomy, there was a big perforation at the
fundus of uterus and a loops of intestine were
seen passing through it and into vagina and out
of vulva. This is shown in following slides.
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Slide showing a loop of intestine coming out a
perforation in anterior wall of uterus. The loop
of intestine on left side has change in colour.
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Same as previous slide at a little close up
view. Bulky Ut. is seen. Loops of intestine were
cut after application of intestinal clamps.
Hanging intestine were pulled out of vulva.
Remaining products of conception were evacuated
from uterus Uterine perforation
was sutured with vicryl.
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The case was handed over to surgical team. The
damaged intestine were resected by the surgical
team and end to end anatomists of intestine was
performed. Pt. was given 3 transfusions and
higher antibiotic cover.
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Conclusion
This slide shows resection and anestomosis of
intestine being performed, by surgical team
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Slide showing loops of intestine and
mesentry, arranged in row on table by a resident.
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Total length of intestine and mesentery was
about 14 feet. You see a resident measuring it.
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The patient had a stormy convalescent but she
survived the surgery.
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We talk a lot about safe mother hood, but how
much safer is safe-motherhood, even in year 2004
(Year in which this happened) in city like
Ahmedabad (Gujarat state-INDIA) What will be the
condition in villages?
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The unqualified doctor, who did this complication
escaped unharmed. We still need to popularize
through media and encourage people, not to get
treatment from unqualified persons and take
treatment from government hospital, where M.T.P.
(Medical termination of pregnancy) is being
performed free of cost, by qualified doctors and
is more safe.
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THANK YOU