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Re: secondary post partum hemorrhage From: R. Daniel Braun (rd.braun@gmail.com) Sun Dec 30 13:51:46 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: R. Daniel Braun: "Re: obstructed labour" Previous message: R. Daniel Braun: "Re: Difficult Case Microcephaly" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: secondary post partum hemorrhage" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: secondary post partum hemorrhage" Reply: Raymond Stephen: "Re: secondary post partum haemorrhage" Sounds like this may have been "Subinvolution of the placental site". In which case treatment with methylergonovine is indicated instead of a D & C. This should always be considered in cases of Delayed PPH. It usually should be suspected if the patient has gone at least one 24 hour period with no lochia. If there has been no such 24 hour period then retained products is more likely. Doing a D&C in a patient with subinvolution is one of the more common causes of Asherman's Syndrome. Dan On Dec 29, 2007 6:45 PM, tirupati seshasai <drseshasai@yahoo.co.in> wrote: > A 31 years aged primi gravida at 40 weeks delivered with vacuum > extraction indication persistant occipito posterior. the neonate and mother > were healthy and discharged. on 7Th postnatal day at 3.00am she was > brought with bleeding vaginally. On examination the episiotomy sight is > healthy and the uterus is around 8 to 10 weeks size and bleeding from the > cervical os seen continuously and clots were evacuted. > suspecting fragments of placental products a gentle D&C done. but no > products seen. The haematological exam is normal.She was appearing pal > our so blood transfused. with in 10 minutes the bleeding stopped. the usg of > pelvis shown as normal study, > > on 14Th day of post natal day again she reported with heavy bleeding. on > examination the bleeding is from the cervical canal profusely bleeding. > > the haematological exam is with in normal limits, > she was transfused with 2 paints of B Positive freshly collected blood and > the bleeding stopped with in 30 minutes. > in this case I found DISSEMINATED INTRAVASCULAR COAGULATION OR SUB ACUTE > INFECTION which made to struggle to save the mother. > Hope she won't report on 21st post natal day with hemorrhage. > -- R. Daniel Braun, MD FACOG(L) CMT Professor Emeritus Dept. of Obstetrics and Gynecology Indiana U. School of Medicine R. Daniel Braun "Science without Religion is LAME; Religion without Science is BLIND" Einstein 1941 Next message: R. Daniel Braun: "Re: obstructed labour" Previous message: R. Daniel Braun: "Re: Difficult Case Microcephaly" Next in thread: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: secondary post partum hemorrhage" Reply: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: secondary post partum hemorrhage" Reply: Raymond Stephen: "Re: secondary post partum haemorrhage"

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