A case report of modified Porro caesarean hysterectomy on mother with hemorrhagic shock and severe anemia due to placental abruption

BACKGROUND: Modified Porro caesarean hysterectomy is an operation technique that is used in management of emergency obstetric complication in the presence of life threatening hemorrhage. This technique was developed by Eduardo Porro in 1876 consisting of uterine corpus amputation after caesarean section and suturing of the cervical stump into the abdominal wall incision. CASE: A G6P4, 44-year-old woman with 30–31 weeks of gestation referred presented with heavy vaginal bleeding since 8 h. She was unconscious, her vital sign: Blood Pressure 90/70mmhg. Obstetric examination revealed fundal height corresponding to 26 weeks gestation, single fetus with transverse lie with hand presentation, fetal heart didn’t found. Per vaginal examination showed cervical dilation of 4 cm, ongoing heavy bleeding from canalis cervicalis. Arm was felt on vaginal toucher. Her hemoglobin was 6.3g/dL. Emergency caesarean section was planned. After the peritoneum was opened, hematoma in the uterus was found and the blood pressure dropped to 60/30 the team was decided to perform modified Porro caesarean hysterectomy, hysterectomy was performed without delivering the baby. Patient was hospitalized for 4 days before discharged. CONCLUSION: The primary concern of modified Porro cesarean hysterectomy is to save the mother by shorten the operation and stop the bleeding quickly.