The retained fetal skull: An obstetrician’s night mare

In the growing era where safe abortion practices are advocated, we still encounter the complications of illegal abortions. We present a case of 40-year-old P3L3A1 referred to our tertiary care center with history of massive bleeding following illegal second trimester abortion and USG revealing the retained fetal skull. The retained fetal skull was removed but there was torrential hemorrhage on attempting to remove the placental mass. Balloon tamponade and hemostatic agents failed leading to laparotomy and discovery of placenta accrete syndrome which eventually lead to hysterectomy, Intensive ICU care and admission, massive blood transfusion and ultimately contributing to maternal near miss situation.

Keywords: Second trimester abortion, Massive hemorrhage, Retained skull, Placenta accrete syndrome.