Obstetrics / Caesarean section
Hysterectomy following Caesarean section
Jackie was an insulin dependant diabetic, who became pregnant for the first time. Her blood sugar levels were difficult to control and there was evidence of a very large baby: as a result, it was decided to perform a Caesarean section at 37 weeks. The procedure appeared to be straightforward and the baby was delivered in good condition. However, there was a massive postpartum haemorrhage due to an atonic uterus, followed by disseminated intravascular coagulation (DIC). After drug treatment failed , a hysterectomy was performed. PMS concluded that it was reasonable to perform Caesarean section, and that it was performed in a competent manner. Failure of the uterus to contract is a recognised complication, which usually responds to drug treatment, but, on this occasion, hysterectomy was necessary to save the mother's life. There was no evidence of negligence.
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