Re: Cytotec and hypotonic uterus
From: Rupak Roy (rupakray@caltiger.com)
Mon Apr 10 21:06:45 2000
Any possibility of a placental abruption? That will present in a pretty
similar manner.
How did you diagnose amniotic fluid embolism?
Rupak Ranjan Roy
MRCOG
>----- Original Message -----
From: Tonya Von Brooks, CPM <nbwc@ix.netcom.com>
To: Multiple recipients of list OB-GYN-L <ob-gyn-l@forum.obgyn.net>
Sent: 11 April 2000 02:48
Subject: Re: Cytotec and hypotonic uterus
> Dear Diane ,
> What an ordeal ! It sounds like you did a fine job in saving this lady
and
> her baby .I would also like to know what's on your card . Would you
> characterize her UCs as teutonic ?
> Tonya Brooks
> Diane Petersen wrote:
>
> > The mother was in early labor with ruptured membranes. She experienced
> > another gush of fluid followed by much more painful contractions,
> > diarrhea and became anxious. Fetal bradycardia was present after these
> > changes occurred in the mother. She did not show signs of
> > cardiopulmonary compromise. At C/S for fetal bradycardia there was
> > normal clotting at the start of the case. It was when I was closing the
> > fascia that oozing began and DIC became apparent. We were then in the
> > OR for another 3-4 hours trying to correct the coagulopathy and uterine
> > hypotonia so that I could close the abdomen.
> > Thankfully, this was the first amniotic fluid embolism to occur in my
> > career (15 years). I have carried a card in my wallet with a protocol
> > for AFE management since I was an intern. After my recent experience I
> > have been able to add a few more things that were advantageous to my
> > patient. I also have reviewed the literature on the subject and found
> > that fetal bradycardia may be the first sign of an AFE. There are three
> > classic presentations of AFE: cardiopulmonary collapse, hemorrhage/DIC,
> > and seizure. In residency I only learned of the first presentation. I
> > hope to never see this again.
> >
> > Diane Petersen MD FACOG
> > Mpls MN
> > Private practice
>
