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Massive transfusion obstetrics

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https://www.readbyqxmd.com/read/27755062/amniotic-fluid-embolism
#1
Courtney Stanley Sundin, Lauren Bradham Mazac
Amniotic fluid embolism (AFE) is a rare but serious and potentially deadly complication of pregnancy that is unpreventable and unpredictable. Most AFE events occur during labor; however, approximately one third happen during the immediate postpartum period. Presentation is abrupt and thought to be an abnormal response to fetal materials entering maternal circulation through the placental insertion site. Care providers must recognize the signs and symptoms of AFE and react quickly to treat potential complications...
January 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/27666754/obstetrical-transfusion-medicine-knowledge-among-faculty-and-trainee-obstetricians-a-prospective-knowledge-assessment-study
#2
S Morris, M H Yudin, J Callum, A Alam, J Herold, Y Lin
OBJECTIVES: To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool. BACKGROUND: Transfusion issues are common in obstetrical patients. METHODS: Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC)...
September 26, 2016: Transfusion Medicine
https://www.readbyqxmd.com/read/27651589/return-to-the-operation-theatre-an-analysis-of-repeat-surgeries-in-operative-obstetrics
#3
Maimoona Ahmed, Sunil T Pandya, Tarakeswari Supraneni
PURPOSE: To determine the risk factors and associated comorbidities with a relaparotomy after primary surgery in pregnant mothers and to identify preventable causes. METHODS: A retrospective observational study was done at a tertiary care centre from January 2009 till August 2014. All records of exploratory laparotomy following primary surgery in the obstetric population during this period were retrieved from the hospital database and analysed. RESULTS: The incidence of relaparotomy was 0...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27651584/use-of-condom-tamponade-to-manage-massive-obstetric-hemorrhage-at-a-tertiary-center-in-rajasthan
#4
Rakesh Hasabe, Kumud Gupta, Pallavi Rathode
INTRODUCTION: Conventionally postpartum hemorrhage (PPH) has been defined as blood loss of more than 500 ml following vaginal delivery and 1000 ml following a cesarean section [Pritchard et al. in Am J Obstet Gynecol 84(10):1271-1282, (1962)]. Another definition labels PPH as any blood loss which causes a 10 % drop in hematocrit [Combs et al. in Obstet Gynecol 77:69-76, (1991)] or which threatens the hemodynamic stability of the patient and necessitates blood transfusion [Prendiville et al...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27592155/major-obstetric-hemorrhage
#5
A Le Gouez, F J Mercier
Major obstetric hemorrhage is a challenge for anesthesiologists because it remains responsible for over 10% of maternal deaths in high-income countries. A standardized multidisciplinary management, described in locally validated protocols and based on international guidelines is mandatory to prevent these deaths. The first difficulty relies on the systematic underestimation of the bleeding. Collection bags must be used to facilitate the diagnosis and therefore rapid management. The etiologies in antenatal or postpartum must be well-known in order to be treated adequately...
November 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
https://www.readbyqxmd.com/read/27488384/how-do-we-manage-blood-product-support-in-the-massively-hemorrhaging-obstetric-patient
#6
Kerry L O'Brien, Lynne Uhl
Obstetric hemorrhage remains a leading cause of maternal mortality with more than 140,000 deaths annually worldwide. Abnormal placentation has increased to become the most common diagnosis requiring massive blood transfusion in obstetrics, with uterine atony a close second. At our institution, as well as nationwide, there has been a steady increase in pregnancies complicated by abnormal placentation, including accreta, increta, and percreta. Providers at our facility created the New England Center for Placental Disorders in May 2015 to address these complex patients...
September 2016: Transfusion
https://www.readbyqxmd.com/read/27193989/should-warm-fresh-whole-blood-be-the-first-choice-in-acute-massive-hemorrhage-in-emergency-conditions
#7
Pınar Kendigelen, Zeynep Kamalak, Deniz Abat
Early management of rapid massive hemorrhage requires early administration of blood products and rapid surgical control of bleeding. Professionals in peripheral hospitals with limited resources often work under conditions similar to those in the military. Described in the present report are 3 cases in which warm fresh whole blood (WFWB) was used in patients with massive bleeding who presented to a peripheral hospital that had no blood products suitable for emergency conditions. Described first is the case of a 16-year-old female patient who underwent emergency cesarean section...
March 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27184441/massive-obstetric-hemorrhage-current-approach-to-management
#8
E Guasch, F Gilsanz
Massive obstetric hemorrhage is a major cause of maternal mortality and morbidity worldwide. It is defined (among others) as the loss of>2,500ml of blood, and is associated to a need for admission to critical care and/or hysterectomy. The relative hemodilution and high cardiac output found in normal pregnancy allows substantial bleeding before a drop in hemoglobin and/or hematocrit can be identified. Some comorbidities associated with pregnancy can contribute to the occurrence of catastrophic bleeding with consumption coagulopathy, which makes the situation even worse...
June 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27075198/pre-delivery-fibrinogen-predicts-adverse-maternal-or-neonatal-outcomes-in-patients-with-placental-abruption
#9
Liangcheng Wang, Shigetaka Matsunaga, Yukiko Mikami, Yasushi Takai, Katsuo Terui, Hiroyuki Seki
AIM: Placental abruption is a severe obstetric complication of pregnancy that can cause disseminated intravascular coagulation and progress to massive post-partum hemorrhage. Coagulation disorder due to extreme consumption of fibrinogen is considered the main pathogenesis of disseminated intravascular coagulation in patients with placental abruption. The present study sought to determine if the pre-delivery fibrinogen level could predict adverse maternal or neonatal outcomes in patients with placental abruption...
July 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/26866844/fetomaternal-hemorrhage-complicated-pregnancy-risks-identification-and-management
#10
Vedran Stefanovic
PURPOSE OF REVIEW: This article aims not only to review recent literature about the clinical features of massive fetomaternal hemorrhage (FMH) and identification of risk factors, but also to alert obstetricians and pediatricians to this underdiagnosed and underestimated severe obstetrical issue. In addition, a simplified flow chart for the antenatal management of suspected FMH is proposed. RECENT FINDINGS: Improvements in obstetrical and neonatal care have decreased perinatal morbidity and mortality and the rate of stillbirth...
April 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26842538/early-blood-transfusion-and-resolution-of-disseminated-intravascular-coagulation-associated-with-massive-subgaleal-hemorrhage
#11
Houchang Modanlou, Shandee Hutson, Allan Thurman Merritt
A male infant delivered to a primipara woman following vacuum applications. He was vigorous at birth, with small caput and scalp bruising. His head was enlarging; he became pale with respiratory distress. Subgaleal hemorrhage (SGH) was suspected. His hematocrit was noted to be 26.2 percent prior to transfusion of O, Rh-negative blood (40 mL/kg). Moderate disseminated intravascular coagulation (DIC) was noted at 12 hours of age. Posttransfusion of fresh frozen plasma (FFP), his condition became stable, and DIC gradually resolved...
2016: Neonatal Network: NN
https://www.readbyqxmd.com/read/26756709/transfusion-medicine-illustrated-massive-transfusion-in-an-obstetric-emergency
#12
Matthew Hulse, Amanda N Fader, Hua Shan, Nana Benneh, Aaron A R Tobian
No abstract text is available yet for this article.
January 2016: Transfusion
https://www.readbyqxmd.com/read/26694742/the-epidemiology-and-outcomes-of-women-with-postpartum-haemorrhage-requiring-massive-transfusion-with-eight-or-more-units-of-red-cells-a-national-cross-sectional-study
#13
L Green, M Knight, F M Seeney, C Hopkinson, P W Collins, R E Collis, Nab Simpson, A Weeks, S S Stanworth
OBJECTIVE: To ascertain the incidence of massive transfusion (MT) in obstetrics in the UK, and describe its management and clinical outcomes. DESIGN: A population-based cross-sectional study conducted through the UK Obstetric Surveillance System (UKOSS). SETTINGS: All UK hospitals with consultant-led maternity units. POPULATION: Any pregnant woman at ≥20 weeks of gestation receiving ≥8 units of red blood cells within 24 hours of giving birth, from July 2012 to June 2013...
December 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26683982/the-haematological-features-and-transfusion-management-of-women-who-required-massive-transfusion-for-major-obstetric-haemorrhage-in-the-uk-a-population-based-study
#14
MULTICENTER STUDY
Laura Green, Marian Knight, Frances Seeney, Cathy Hopkinson, Peter W Collins, Rachel E Collis, Nigel A B Simpson, Andrew Weeks, Simon J Stanworth
Understanding the coagulopathy of major-obstetric-haemorrhage (MOH) that leads to massive-transfusion (MT) is fundamental to improving outcomes. This study reports on the haematological features and transfusion management of women experiencing MT [defined as transfusion of ≥8 units of red blood cells (RBC) within 24 h of delivery]. One hundred and eighty-one cases [median (interquartile range; IQR) age 33 years (29-36)] were identified from all UK hospitals, using the UK Obstetric Surveillance System between July 2012 and June 2013...
February 2016: British Journal of Haematology
https://www.readbyqxmd.com/read/26597396/israeli-survey-of-anesthesia-practice-related-to-placenta-previa-and-accreta
#15
A Ioscovich, D Shatalin, A J Butwick, Y Ginosar, S Orbach-Zinger, C F Weiniger
BACKGROUND: Anesthesia practices for placenta previa (PP) and accreta (PA) impact hemorrhage management and other supportive strategies. We conducted a survey to assess reported management of PP and PA in all Israeli labor and delivery units. METHODS: After Institutional Review Board waiver, we surveyed all 26 Israeli hospitals with a labor and delivery unit by directly contacting the representatives of obstetric anesthesiology services in every department (unit director or department chair)...
April 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26573939/-thromboelastography-guided-transfusion-in-a-patient-with-amniotic-fluid-embolism-and-massive-coagulopathic-bleeding
#16
Renee Anita Bøgeskov, Lone Fuhrmann, Niels Klarskov
Amniotic fluid embolism is a serious and devastating complication in obstetrics. Despite a low incidence of 1-6:100.000, it remains one of the leading causes of maternal death in developed countries. Several risk factors have been proposed, but studies are conflicting, and to date there are no ways to predict or prevent this condition. Despite early and aggressive treatment, mortality and risk of neurological impairment remain high. We present a classic case of amniotic fluid embolism during labour and briefly discuss the current recommendations for treatment...
November 2, 2015: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/26421705/checklists-and-multidisciplinary-team-performance-during-simulated-obstetric-hemorrhage
#17
G Hilton, K Daniels, S N Goldhaber-Fiebert, S Lipman, B Carvalho, A Butwick
BACKGROUND: Checklists can optimize team performance during medical crises. However, there has been limited examination of checklist use during obstetric crises. In this simulation study we exposed multidisciplinary teams to checklist training to evaluate checklist use and team performance during a severe postpartum hemorrhage. METHODS: Fourteen multidisciplinary teams participated in a postpartum hemorrhage simulation occurring after vaginal delivery. Before participating, each team received checklist training...
February 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/26376560/-a-case-of-fetal-death-resulting-from-a-massive-fetomaternal-hemorrhage
#18
M Denef, X Capelle, C Vanlinthout, S Lepage, P Emonts
We report the case of a late stillbirth which unexpectedly occurred in a patient without any medical history and after a meticulous obstetrical follow up. Stillbirth is unfortunately not unusual and implies a complete etiological work up. In the present observation, the Kleihauer test and anatomoclinical examination concluded that the death was due to an acute cerebral anoxy resulting from a massive fetomaternal hemorrhage (HFM). HFM is rarely considered as the cause of a late stillbirth, but its occurrence is certainly underestimated...
July 2015: Revue Médicale de Liège
https://www.readbyqxmd.com/read/26373682/successfully-treated-severe-obstetric-sepsis-and-acute-respiratory-distress-syndrome-with-extracorporeal-membrane-oxygenation
#19
Rimantas Benetis, Ruta Nadisauskiene, Edmundas Sirvinskas, Tadas Lenkutis, Adakrius Siudikas, Vytaute Kadusauskaitė, Dalia Railaitė, Arturas Sukovas, Vytautas Abraitis
We report a unique clinical case about an 18-year-old woman, immediately post-partum after an urgent C-section, who survived severe sepsis, acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC) and was successfully treated with 11 different antibiotics, massive blood transfusions and repetitive surgeries and was on extracorporeal membrane oxygenation (ECMO) support for 22 days. Although, ECMO is a time-limited procedure and most manufacturers do not advise more than 14 days of use, the situation for this patient was life-threatening and ECMO, despite the dangerous risks listed above, was the only way to win time for the lungs to recover and for treatment of the underlying disease, while maintaining adequate oxygenation and circulation...
May 2016: Perfusion
https://www.readbyqxmd.com/read/26348379/an-update-on-the-use-of-massive-transfusion-protocols-in-obstetrics
#20
REVIEW
Luis D Pacheco, George R Saade, Maged M Costantine, Steven L Clark, Gary D V Hankins
Obstetrical hemorrhage remains a leading cause of maternal mortality worldwide. New concepts involving the pathophysiology of hemorrhage have been described and include early activation of both the protein C and fibrinolytic pathways. New strategies in hemorrhage treatment include the use of hemostatic resuscitation, although the optimal ratio to administer the various blood products is still unknown. Massive transfusion protocols involve the early utilization of blood products and limit the traditional approach of early massive crystalloid-based resuscitation...
March 2016: American Journal of Obstetrics and Gynecology
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