Re: OB: this ever happened to you before?
From: Harrison Sheld (hsheld@anv.net)
Tue Mar 9 06:49:16 2004
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TJ: you are unreal!
Terrence.Jones@kp.org wrote:
>
> We've had two cases in past 18 years (i know of) involving term
> pregnancy, hemoperitoneum, hemodynamically unstable, intact uterus.
> The first involved a canalicular malformation of the inferior vena
> cava (vascular surgeons called to repair); the second was a small
> hemangioma feeding a mesonephric duct remnant in the left mesosalpinx.
> Unpredictable. Unlikely to occur in the first place, much less -
> recur. I think You're right to point out, in these cases, the phrenic
> nerve is our friend - it tells us to think peritoneal, rather than
> perineal or retroperitoneal (broad lig). As usual. good job. tj
>
> gklein@neopolis.net (Geffrey Klein, MD)
> Sent by: ob-gyn-l@obgyn.net
>
> 03/08/2004 11:43 AM
> Please respond to ob-gyn-l
>
> To: Multiple recipients of list OB-GYN-L
> <ob-gyn-l@dns.obgyn.net>
> cc:
> Subject: OB: this ever happened to you before?
>
> 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
>
