The case A 34-year-old female at 37 weeks' gestation with twins was admitted for induction of labor due to suspected preeclampsia. Successful delivery of two healthy baby boys was followed by concern for continuing post-partum hemorrhage. The initial diagnosis of cervical laceration was temporized with sutures and a Bakri balloon. The bleeding was resistant to the effects of oxytocin, Cytotec, Hemabate, and uterine massage. The patient had experienced 2 L of blood loss and counting. The decision to proceed to an emergent cesarean section required quick thinking and even quicker action. Of course, the blood that was contained in the abdomen came out to greet us quickly, in the form of a rapid gush. How quickly an oozing cervical injury transformed into disseminated intravascular coagulation. Patient care Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Communicate effectively and demonstrate caring and respectful behaviors when interacting with patients and their families. The case originally began with an almost painless vaginal delivery. Result: happy parents, happy babies, happy doctors. So we let down our guard and wrap up the vaginal bleeding, reassuring the family that we are almost done. The nurses escort the father and babies to the recovery room, assuring him that we will be out to meet him in a few minutes.
|Original language||English (US)|
|Title of host publication||Core Clinical Competencies in Anesthesiology|
|Subtitle of host publication||A Case-Based Approach|
|Publisher||Cambridge University Press|
|Number of pages||5|
|State||Published - Jan 1 2010|
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