Dr. Prathibha Santosh, Amera Shweita, Marwa Mamdouh
{"title":"Anaesthetic management of atonic postpartum haemorrhage secondary to trauma during normal vaginal delivery: A case report","authors":"Dr. Prathibha Santosh, Amera Shweita, Marwa Mamdouh","doi":"10.33545/26643766.2023.v6.i3b.423","DOIUrl":null,"url":null,"abstract":"PPH is a leading cause of maternal mortality which has several aetiologies. Effective management including resuscitation, hemostasis, and identification and treatment of the cause in these cases is important. This case reports a parturient patient G4P3L3 40 weeks and 1 day gestation who suffered from PPH after normal vaginal delivery. On exploration an uncommon right broad ligament hematoma was detected which was drained, ligating the hypogastric artery. A hysterectomy was performed. During the procedure general anesthesia with ketamine was administered. Haemostasis was maintained by transfusing 2 units of packed red blood cells and 1 unit of fresh frozen plasma (FFP). Inj Fibrinogen 2 grams and Inj. Tranexamic acid 1 gram was infused intravenously. In total, 9 units of packed RBCs, 6 units of FFP, 4 units of platelets, and 2 liters of crystalloids were transfused during the entire procedure. 10 ml of 10 % calcium gluconate was also given after every 3 units of packed RBC transfusion. The patient was weaned off the ventilator after stabilizing the vitals and discharged 5 days later.","PeriodicalId":14146,"journal":{"name":"International Journal of Medical Anesthesiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Medical Anesthesiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33545/26643766.2023.v6.i3b.423","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
PPH is a leading cause of maternal mortality which has several aetiologies. Effective management including resuscitation, hemostasis, and identification and treatment of the cause in these cases is important. This case reports a parturient patient G4P3L3 40 weeks and 1 day gestation who suffered from PPH after normal vaginal delivery. On exploration an uncommon right broad ligament hematoma was detected which was drained, ligating the hypogastric artery. A hysterectomy was performed. During the procedure general anesthesia with ketamine was administered. Haemostasis was maintained by transfusing 2 units of packed red blood cells and 1 unit of fresh frozen plasma (FFP). Inj Fibrinogen 2 grams and Inj. Tranexamic acid 1 gram was infused intravenously. In total, 9 units of packed RBCs, 6 units of FFP, 4 units of platelets, and 2 liters of crystalloids were transfused during the entire procedure. 10 ml of 10 % calcium gluconate was also given after every 3 units of packed RBC transfusion. The patient was weaned off the ventilator after stabilizing the vitals and discharged 5 days later.