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Re: bad glad???From: Ealgail@aol.comSat Feb 26 08:33:41 2000
I had exactly the same experience with a vasa praevia, as a second year resident. An amniotomy with (in our case) a small gush of blood followed by bradycardia that did not respond to anything. Emergency c/section (we were only 20 feet from the OR) gave us a depressed baby Apgars 0 and 3, that was transfused with O neg. blood and subsequently did well. From amniotomy to delivery was 20 minutes. In private practice, I had another case; the mother had SROM at home with a gush of blood which she said "soaked a towel". She was told to come to the hospital immediately but did not arrive for 30 minutes. On arrival sono showed the fetus was not moving and bradycardic at a rate of 50-60. An emergency c/section revealed the palest infant I have ever seen. (This c/section was done under local because the anesthesiologist was at home and didn't arrive for 40 minutes). The infant was limp and blue, apgar 0 and 2. She was transfused and resuscitated, and followed for one year in a high risk program. She appeared to be normal at that time. These two cases showed me that infants, with their fetal hemoglobin and dolphin reflexes, probably have more reserve that we know. The outcomes may depend on the amount of the bleed and the size of the vessel that ruptures, as well as the facilities available to deliver the fetus quickly. Linda Linda Morrison-Boczar, M.D. FACOG
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