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Sci J Iran Blood Transfus Organ 2019; 16(1): 57-62
|
Massive obstetric hemorrhage in a case
with placenta accreta
Behnaz F.1, Chegini A.2, Azizi Farsani H.R.1, Shekari R.1
1Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
Abstract
Background and Objectives
Post-partum is one of the common causes of maternal mortality. Massive obstetrics hemorrhage may occur due to several etiologies such as Placenta Accreta. Massive transfusion protocols for obstetrics can reduce mortality and morbidity rate.
Case
A 28 year old patient who was an elective candidate for second cesarean without any particular disease was under spinal anesthesia and gave birth to a healthy baby. But after 25 minutes from the onset of the operation, the patient suffered from a marked drop in blood pressure and decrease in consciousness. Due to hemorrhage shock od an estimated blood loss of nearly 3500
cc, she was intubated and prescribed isotonic and hypertonic fluids, colloids and blood components. Her diagnosis was placentra accreta and to control hemorrhage, hysterectomy was done.
Conclusions
Preoperative suspension for Placenta Accreta abnormalities should alert the anesthesia provider to potential massive blood loss. Preoperative effective communication among all obstetric caregivers is imperative.
Key words: Placenta, Anesthesia, Obstetrics, Blood Transfusion, Obstetric Labor Complications
Received: 24 Jun 2018
Accepted: 22 Dec 2018
Correspondence: Chegini A., MD. Specialist in Anesthesiology. Assistant Professor of Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine.
P.O.Box: 14665-1157, Tehran, Iran. Tel: (+9821) 82052256; Fax: (+9821) 88601599
E-mail:
a.chegini@ibto.ir