Lérias-Cambeiro Muriel, Rodrigues Anabela, Taborda Inês, Lança Filipa
Department of Anaesthesiology, Hospital de Santa Maria. Centro Hospitalar Lisboa Norte, Portugal.
Department of Immuno-Hemotherapy. Hospital de Santa Maria. Centro Hospitalar Lisboa Norte. Portugal.
Acta Med Port. 2018 Sep 28;31(9):511-514. doi: 10.20344/amp.9795.
Postpartum haemorrhage is an important health issue worldwide, and it can be caused by uterine atony, retained placental tissue, trauma or coagulation disorders. Although coagulopathy represents a rare cause, it is a significant contributor to postpartum haemorrhage with poor outcomes. Associated with high morbidity and mortality rates, postpartum haemorrhage demands prevention, prompt diagnosis and effective management. We describe a unique case of severe coagulopathy caused by underestimated blood loss during caesarean section without postpartum bleeding, in which transfusion requirements were thromboelastometry-guided. This case report depicts how an early multidisciplinary approach and patient-centred care in an obstetric emergency contributes to a positive outcome from a challenging situation, enabling the prevention of an imminent, catastrophic haemorrhage.
产后出血是全球重要的健康问题，它可由子宫收缩乏力、胎盘组织残留、创伤或凝血功能障碍引起。虽然凝血功能障碍是产后出血的罕见原因，但却是导致产后出血且预后不良的重要因素。产后出血发病率和死亡率高，需要进行预防、及时诊断和有效管理。我们描述了一例剖宫产时因失血估计不足导致严重凝血功能障碍但无产后出血的独特病例，该病例输血需求由血栓弹力图引导。本病例报告描述了产科急诊中早期多学科方法和以患者为中心的护理如何在具有挑战性的情况下促成积极结果，从而预防即将发生的灾难性出血。
