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Re: secondary post partum hemorrhage From: Robert J. Carpenter, Jr. MD, JD (zygote@icsi.net) Sun Dec 30 15:29:31 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Difficult Case Microcephaly" Previous message: GIN11153@aol.com: "Re: obstructed labour" When you say "the hematological exam is normal" What do you mean? Did you specifically look for Von Willibrand's disease? Since about 20-25% of VW deficient patients will have a first delayed hemorrhage, that should be excluded, since they have increased risk in subsequent pregnancies. Please advise! Bob On 29 Dec 2007 at 17:46, tirupati seshasai 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 the 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 caseI found DISSEMINATED INTRAVASCULAR COAGULATION OR SUBACUTE INFECTION which made to struggle to save the mother. > Hope she won't report on 21st post natal day with hemorrhage. -- Robert J. Carpenter, Jr. MD, JD 6624 Fannin, #2720 Houston, TX 77030 (O) 713-795-4600 (F) 713-795-4422 "Life is difficult" The Road Less Travelled by Scott Peck Next message: art fougner, md: "Re: Difficult Case Microcephaly" Previous message: GIN11153@aol.com: "Re: obstructed labour"

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