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Re: OB: this ever happened to you before? From: Joanne Bulley, MD (islesannie@yahoo.com) Mon Mar 8 20:52:47 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Terrence.Jones@kp.org: "Re: OB: this ever happened to you before?" Previous message: Zachariah Newton: "Cajuns have voice" In reply to: Efrain Ramirez: "Re: OB: this ever happened to you before?" Next in thread: Terrence.Jones@kp.org: "Re: OB: this ever happened to you before?" Never had that ... but I did have a patient who was and OB-RN with her 4th or 5th pregnancy at about 32 weeks have the onset of severe abdominal pain during a bout of severe coughing with bronchitis on top of her underlying asthma. She was also moving about 5 hours away and was working on the maternity unit there. The pain kept increasing - until baby didn't look so good anymore -- I can't recall if they figured out what was going on before they operated. She had ruptured one of the (R - I think) inferior epigastric vessels - so was having a bleed into her abdominal wall. By the time they operated, she had lost enough that they were worried about the baby - so he was delivered early - then she went on to have the whole DIC thing etc. She received a numbe of units of blood as well. Eventually both mom & baby did well. They then had to harrass the HMO - because she didn't make any attempts to get care in our town! How many times have we all had someone call and say, "I was coughing really hard and now my chest / abdomen really hurst - what is it doc - am I OK?" Joanne At Mon, 8 Mar 2004, Efrain Ramirez wrote: > >Never - good call! > >>At Mon, 8 Mar 2004, Geffrey Klein, MD wrote: >> >>Primigravida labored and delivered this AM. I was called to return to >>the unit 15 min later due to tachycardia and hypotension. No vaginal >>bleeding, uterus was firm. No perineal hematoma noted. She was very >>pale and was complaining of shoulder pain. >> >>I figured she was having intra-abdominal bleeding. So, stat H/H was >>drawn and we went to the OR. Just before starting the surgery, her H/H >>was 7.2/21 (pre del was 11/32) >> >>Opened her peritoneal cavity and there was 2 liter of blood. Uterus was >>exteriorized and there was a brisk bleeder from the posterior right >>uterus where a plexus of varicose veins was noted. There was no uterine >>rupture. This was repaired with suture ligation and 4 units of blood >>were given. >> >>Anyone ever had this happen before? What about future pregnancy? Thanks… >> >>-- >>_______________________ >>Geffrey H. Klein, MD >>_______________________ >>_______________________ >>_______________________ >>gklein@icsi.net >>450 Blossom Suite C >>Webster, TX 77598 >> >-- >"The opposite of a correct statement is a false statement. >But the opposite of a profound truth may well be another profound truth." > >Niels Bohr (1885 - 1962) > -- Joanne Bulley, MD Keene, NH, USA ----- "It is easier to understand a nation by listening to its music than by learning its language" -Anonymous Next message: Terrence.Jones@kp.org: "Re: OB: this ever happened to you before?" Previous message: Zachariah Newton: "Cajuns have voice" In reply to: Efrain Ramirez: "Re: OB: this ever happened to you before?" Next in thread: Terrence.Jones@kp.org: "Re: OB: this ever happened to you before?"

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