Description

A 38 year old secretary was seen at the
outpatients clinic with a 9-month history of loss
of weight, poor appetite, nausea, extreme
tiredness and lethargy to the extent that she was
having to take naps during the day. She was
previously a very energetic person. She also
complained of occasional dizziness and was
particularly concerned about the fact that her
lower segment caesarean section (LSCS) scar was
“going a horrible brown colour”. She also noticed
that her areolae had darkened. She had normal
menstruation in the preceding 10 months.

In her post medical history, her second child
was born 13 months ago, at 39 weeks of gestation
by emergency LSCS for fetal distress. She made
an uneventful recovery from this procedure but
reported that she had bled considerably after it.
Her first child, born 5 years ago was delivered
normally at term.