Fibroid uterus with DVT

45 yr old female para 1 with fibroid uterus of 26 weeks gravid uterus Chief Complaints Presented with heavy menstrual bleeding for 6 months History Patient had menorrhagia for 6 months and swelling of leg leg sudden in onset after trivial trauma for 1 day. Known case of diabetes with Hb A1C 6.7% Vitals Pulse , BP stable Physical Examination 26 weeks enlarged uterus, mobile, non tender. Investigations Hb 5.6 gm%. HbA1c 6.7% .ultrasound leg vein DVT of left popliteal, femoral vein Management Kindly opine on further management . Thanking you.

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45 year old ,mother of one child. Comorbidities Menorrhagia severe enough to cause severe anemia . DVT Challenging . Needs hospitalisation. LMWH, blood transfusions, IV iron , tight control of sugar . Look for Pulmonary embolism. After stabilizing patient , Laparoscopic hysterectomy suggested .

Thank you ,Dr Prakash
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Admit her build her Hb by blood transfusions and as she is bleeding much so hysterectomy need to be done , but before this surgery opinion for DVT & maintain sugar level

Hospitalization, blood transfusion , diabetes control and hysterectomy is the ideal way in this case

Admission in view of severe Anemia to be managed with at least 2point blood transfusion, then parentral iron and haematenics, diabetes management review with surgeon for DVT , Inj luprolide monthly for 6month will help to decrease fibroid size and build up hb till her gc improve for definitive management i.e hysterctomy .

Blood transfusion for blood loss management Iron n folic acid supplements Hysterectomy final resolution if not medically treated Diabetes be brought in control with antidiabetics and aloe vera syrup or phalsa syrup. Anticoagulants for dvt.

Hb very low due to loss of blood last 6months bleeding,first manage anaemia then hystrectomy because of age of the pt

Antibiotics anti coagulation control diabetes anemia