Emergency Hysterectomy Following Placental Abruption in a Patient With a History of Substance Abuse: A Case Report

Cureus. 2024 Apr 10;16(4):e57997. doi: 10.7759/cureus.57997. eCollection 2024 Apr.

Abstract

Placental abruption is a serious medical condition that can occur during pregnancy, involving the premature separation of the placenta from the inner uterine wall before childbirth. This detachment often leads to severe bleeding, and if conventional methods prove ineffective in managing the bleeding, a hysterectomy may be deemed necessary to ensure the mother's safety. This case report details the management of a 22-year-old female, gravida IV, para III, who experienced placental abruption during her fourth pregnancy. An emergent cesarean section resulted in severe postpartum hemorrhage and disseminated intravascular coagulation (DIC). Positive drug tests for cocaine and methamphetamines added further complexity, leading to an unplanned hysterectomy for life-saving measures. This case underscores the critical importance of early recognition, multidisciplinary collaboration, and timely intervention in managing obstetric emergencies within the context of substance abuse.

Keywords: cesarian section; cocaine use; disseminated intravascular coagulation (dic); drug and substance abuse; emergency obstetrics; maternal-fetal medicine; placental abruption; placental insufficiency; total abdominal hysterectomy; total hysterectomy.

Publication types

  • Case Reports