Patient Case Study

Case Study: Cesarean Scar Ectopic Pregnancy (CSP)
Dr. Tanuka Das Gupta
Hospital: Peerless Hospital & B K Roy Research Center

Background

Mrs. I. Ghosh, with a history of a previous cesarean section, presented with a new pregnancy. She had suffered the tragic loss of her previous child at 4 years of age.

At around 6 weeks of gestation, she experienced slight vaginal bleeding, prompting immediate medical evaluation.

Clinical Findings

An early ultrasound examination revealed a Cesarean Scar Ectopic Pregnancy (CSP)—a rare but potentially life-threatening condition.
The gestational sac was implanted over the previous uterine scar, protruding towards the abdominal cavity instead of growing within the uterine cavity.

Risk Assessment

Cesarean scar ectopic pregnancy carries serious risks, including:

  • Uterine rupture

  • Massive hemorrhage

  • Emergency hysterectomy

  • Compromised future fertility

The primary objective in this case was to save the uterus and prevent life-threatening complications.

Management & Treatment

Under the care of Dr. Tanuka Das Gupta, a laparoscopic removal of the scar ectopic pregnancy was performed, followed by meticulous repair of the uterine scar.
The procedure was conducted successfully with:

  • No significant blood loss

  • No intraoperative complications

Outcome

  • The patient had an uneventful recovery

  • Discharged the very next day

  • Uterus successfully preserved

  • Advised regular follow-up and future pregnancy planning under close supervision

Clinical Insight

Cesarean Scar Ectopic Pregnancy (CSP) is rare but extremely serious.
Early diagnosis through timely ultrasound and expert surgical management can be life-saving and fertility-preserving.

Key Message:
Awareness, early detection, and minimally invasive surgery can prevent catastrophic outcomes in cesarean scar ectopic pregnancies.

#CesareanScarEctopic #CSP #HighRiskPregnancy #LaparoscopicSurgery #UterusPreservation #DrTanukaDasGupta

Case Study: Life-Threatening Hemoperitoneum in a Patient with Glanzmann Thrombasthenia

Patient Profile

A 19-year-old young woman with a rare negative blood group and a known platelet function disorder—Glanzmann thrombasthenia presented in a critical condition.

Presentation

She was admitted with:

  • Severe abdominal pain

  • Massive internal bleeding (hemoperitoneum)

  • Hemoglobin level of only 4 g/dL, indicating life-threatening blood loss

Imaging revealed blood collected inside the abdomen, secondary to a spontaneous rupture of an ovarian cyst, precipitated by her underlying platelet dysfunction.

Clinical Challenge

This case demanded a highly coordinated, multidisciplinary approach due to:

  • Extremely low hemoglobin

  • Rare negative blood group, making blood procurement difficult

  • Severe platelet functional defect causing uncontrolled bleeding

The patient’s father was extremely supportive, which played a crucial role in timely decision-making and care.

Multidisciplinary Management

Successful management required close collaboration between:

  • Hematologist – for managing Glanzmann thrombasthenia and transfusion strategy

  • Intensivist – for hemodynamic stabilization and critical care

  • Surgical team – for definitive management of intra-abdominal bleeding

Arranging compatible negative blood group transfusions was challenging but achieved through coordinated efforts.

Surgical Intervention

A laparoscopic procedure was performed to:

  • Evacuate approximately 750 ml of blood from the abdominal cavity

  • Control bleeding following rupture of the ovarian cyst

  • Minimize surgical trauma and blood loss in a high-risk patient

Despite the complexity, the procedure was completed successfully.

Outcome

  • The patient stabilized well post-operatively

  • No further bleeding episodes

  • Gradual improvement in hemoglobin levels

  • Discharged in stable condition

She is currently doing well, with continued follow-up advised.

Conclusion

This case highlights the critical importance of a well-equipped multi-specialty hospital, early surgical intervention, and seamless teamwork in managing rare hematological disorders with acute gynecological emergencies.

Wishing this brave young woman a lifetime of happiness, strength, and good health.