Discussions for Module 8: Management of Post Partum Hemorrhage

Questions are answered by module author: Sharon Davies MD FRSPC

Click on a link below to jump to that question, or just scroll down the page:



If the slow ooze you mentioned was not responding to recombinant factor v11 a (or if not available), what will be your line of management? Thanks for the excellent case discussion.

1/1/2007 1:13:52 AM P.V.

Dr. Davies replies:

Since the coagulopathy and anemia were corrected, the other possible drug to try would be tranexamic acid. One would expect that hematology would be consulting by this point and could advise on the use of this drug in this patient. We have used it successfully at this institution for a Jehovah's Witness patient with a major PPH. Aside from that, and of course, continued transfusion to maintain the hemaglobin and keep the coagulopathy under control, the only other option becomes a surgical decision. However, one other approach before surgery could be angiography. If available, one might be able to determine if there is a possibility that embolization would useful, ie, that there are one or two vessels from which the bleeding originates that could be embolized.



In the case you described what was the cause of the cardiac arrest? It looked like sufficient resuscitation within the period available was attempted by the attending teams. Thank you for the detailed review of uterine atony.

12/22/2006 2:32:28 PM U.T.

Dr. Davies replies:

I believe that this patient was hypovolemic, despite the initial response to the fluid bolus. Given the fact she required 8 more units of blood (plus other products) and still ended up with a Hgb of 86 on arrival to ICU suggests that there was ongoing losses that needed to be replaced. The rhythmn at arrest was PEA which is again consistent with hypovolemia.

Submit your own question or comment:

You are invited to ask questions or give comments about Module 8, which will be answered and posted on this Discussion Board. For privacy, your full name and email address will not be posted on our website. Only your initials will be used. (View our Privacy Policy.) We ask for your name and email address in case we require clarification about your question and so that we can email your answer to you. You may leave out your name if you prefer to be anonymous.


Page 1 of 1
Enter your question about Module 8: Management of Post Partum Hemorrhage
Please DO NOT USE YOUR BROWSER'S BACK BUTTON if you wish to change anything. Instead, use the PREVIOUS button (next to SUBMIT). Using your Back button will cause problems with the question submission. Thank you!