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Case 23 - A 35-Year-Old G3P3 Woman with a 12-Week Uterus and a Prior Cesarean Section Who Desires Vaginal Hysterectomy

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
University of Alabama, Birmingham
Lisa Keder
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Mayo Clinic, Rochester
Kimberly S. Gecsi
Medical College of Wisconsin
David Chelmow
Virginia Commonwealth University School of Medicine
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A 35-year-old gravida 3, para 3 presents with complaints of heavy menstrual bleeding. Patient reports her menses have been getting progressively heavier over the last year. She has been on oral contraceptive pills for the last six months, and feels they are not helping. She is experiencing heavy flow requiring her to wear a pad and a tampon together for the first two days of her seven-day cycle. She had a cesarean section for her second child followed by a vaginal birth after cesarean (VBAC) of an 8 lb infant. She has no other surgical history and no medical history and has no known drug allergies. She denies any history of sexually transmitted infections (STIs). Her last cervical cytology six months ago was normal. She is currently taking desogestrol 0.15 mg, 0.03 mg ethinyl estradiol contraceptive pills but she has completed her family and desires definitive therapy. After discussing her treatment options, patient requests a hysterectomy.

Surgical Gynecology
A Case-Based Approach
, pp. 64 - 66
Publisher: Cambridge University Press
Print publication year: 2021

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