BIUC Prevails When All Else Fail As A Successful Haemostatic Method In Uncontrollable PPH In A Case Of Amniotic Fluid Embolism- A Case Report
Journal Title: International Journal of Medical and Health Sciences - Year 2012, Vol 1, Issue 3
Abstract
Amniotic fluid embolism (AFE) was first reported by Richardo Meyer 1926. Amniotic fluid embolism (AFE) occurs in 1/8000 to 1/80,000 deliveries with a maternal mortality ranging from 26% in a recent report to 86% in earlier ones. Neonatal outcome is generally poor with a mortality rate of 20%–25% and, of the survivors, only 50% may be neurologically intact. The presenting signs and symptoms of AFE involve many organ systems. Acute dyspnea or sudden agitation and anxiety are common premonitory symptoms. It is estimated that approximately 10–50% of patients with AFE present with seizures. Rapid decline in pulse oximetry values or sudden absence or decrease in end-tidal carbon dioxide may be apparent. Hemodynamic compromise quickly follows these prodromal signs. We present here a case of AFE with Disseminated Intravascular Coagulation (DIC) in a tertiary care setting but with a situational resource limitation. The ideal requirements for the case management were not met due to the patient’s rare blood group as well as unavailability of fresh frozen plasma or other sophisticated tools. The baby could not be saved, but with the simple and effective technique of a persistent and sustained Bimanual Internal Uterine Compression (BIUC) over almost an hour the haemorrhage was controlled and the patient could be saved.
Authors and Affiliations
K. Vijaya,R. S Bharatwaj
Keywords
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