Perioperative Anesthesia Management of a Patient with Triplet Pregnancy Who Developed Hemorrhage Due to Uterine Atony during Cesarean Section: A Case Report
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Abstract
The incidence of postpartum hemorrhage (PPH) is increased in multiple pregnancies and is an important cause of maternal death. Controlling bleeding and correct anesthesia management during this period are essential.
In our 35-year-old patient with triple pregnancy, hemorrhage due to uterine atony developed during C/S surgery. We aimed to discuss the anesthesia management of PPH in our patient who underwent a total abdominal hysterectomy and bilateral salpingectomy (TAH BS) due to continued bleeding during and after C/S, with literature.
We think that morbidity and mortality rates can be reduced in the perioperative period for PPHs with the help of multidisciplinary approach, rapid action, and close follow-up.
[1] Martin JA, Osterman MJ, Thoma ME. Declines in Triplet and Higher-order Multiple Births in the United States, 1998-2014. NCHS Data Brief. 2016(243):1-8.
[2] Sebghati M, Khalil A. Reduction of multiple pregnancy: Counselling and techniques. Best Pract Res Clin Obstet Gynaecol. 2021; 70:112-122.
[3] Santana DS, Cecatti JG, Surita FG, Silveira C, Costa ML, Souza JP, et al. Twin Pregnancy and Severe Maternal Outcomes: The World Health Organization Multicountry Survey on Maternal and Newborn Health. Obstet Gynecol. 2016; 127(4):631-641.
[4] Wen SW, Demissie K, Yang Q, Walker MC. Maternal morbidity and obstetric complications in triplet pregnancies and quadruplet and higher-order multiple pregnancies. Am J Obstet Gynecol. 2004; 191(1):254-8.
[5] Rao A, Sairam S, Shehata H. Obstetric complications of twin pregnancies. Best Pract Res Clin Obstet Gynaecol. 2004; 18(4): 557-76.
[6] Walker MC, Murphy KE, Pan S, Yang Q, Wen SW. Adverse maternal outcomes in multifetal pregnancies. BJOG. 2004; 111(11): 1294–6.
[7] Butwick AJ, Ramachandran B, Hegde P, Riley ET, El-Sayed YY, Nelson LM. Risk Factors for Severe Postpartum Hemorrhage After Cesarean Delivery: Case-Control Studies. Anesth Analg. 2017; 125(2):523-532.
[8] Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017; 130(4):e168-e186.
[9] Blitz MJ, Yukhayev A, Pachtman SL, Reisner J, Moses D, Sison CP, Greenberg M, Rochelson B. Twin pregnancy and risk of postpartum hemorrhage. J Matern Fetal Neonatal Med. 2020; 33(22):3740-3745.
[10] Hytten F. Blood volume changes in normal pregnancy. Clin Haematol. 1985; 14:601-12.
[11] Fardelmann KL, Alian AA. Anesthesia for Obstetric Disasters. Anesthesiol Clin. 2020; 38(1):85-105.
[12] Bateman BT, Berman MF, Riley LE, Leffert LR. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg. 2010; 110(5):1368-73.
[13] Kozek-Langenecker SA, Imberger G, Rahe-Meyer N, Afshari A; European Society of Anaesthesiology Guidelines Task Force. Reply to: ESA guidelines on the management of severe perioperative bleeding. Eur J Anaesthesiol. 2014; 31(4):241-3.
[2] Sebghati M, Khalil A. Reduction of multiple pregnancy: Counselling and techniques. Best Pract Res Clin Obstet Gynaecol. 2021; 70:112-122.
[3] Santana DS, Cecatti JG, Surita FG, Silveira C, Costa ML, Souza JP, et al. Twin Pregnancy and Severe Maternal Outcomes: The World Health Organization Multicountry Survey on Maternal and Newborn Health. Obstet Gynecol. 2016; 127(4):631-641.
[4] Wen SW, Demissie K, Yang Q, Walker MC. Maternal morbidity and obstetric complications in triplet pregnancies and quadruplet and higher-order multiple pregnancies. Am J Obstet Gynecol. 2004; 191(1):254-8.
[5] Rao A, Sairam S, Shehata H. Obstetric complications of twin pregnancies. Best Pract Res Clin Obstet Gynaecol. 2004; 18(4): 557-76.
[6] Walker MC, Murphy KE, Pan S, Yang Q, Wen SW. Adverse maternal outcomes in multifetal pregnancies. BJOG. 2004; 111(11): 1294–6.
[7] Butwick AJ, Ramachandran B, Hegde P, Riley ET, El-Sayed YY, Nelson LM. Risk Factors for Severe Postpartum Hemorrhage After Cesarean Delivery: Case-Control Studies. Anesth Analg. 2017; 125(2):523-532.
[8] Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017; 130(4):e168-e186.
[9] Blitz MJ, Yukhayev A, Pachtman SL, Reisner J, Moses D, Sison CP, Greenberg M, Rochelson B. Twin pregnancy and risk of postpartum hemorrhage. J Matern Fetal Neonatal Med. 2020; 33(22):3740-3745.
[10] Hytten F. Blood volume changes in normal pregnancy. Clin Haematol. 1985; 14:601-12.
[11] Fardelmann KL, Alian AA. Anesthesia for Obstetric Disasters. Anesthesiol Clin. 2020; 38(1):85-105.
[12] Bateman BT, Berman MF, Riley LE, Leffert LR. The epidemiology of postpartum hemorrhage in a large, nationwide sample of deliveries. Anesth Analg. 2010; 110(5):1368-73.
[13] Kozek-Langenecker SA, Imberger G, Rahe-Meyer N, Afshari A; European Society of Anaesthesiology Guidelines Task Force. Reply to: ESA guidelines on the management of severe perioperative bleeding. Eur J Anaesthesiol. 2014; 31(4):241-3.
| Files | ||
| Issue | Vol 9 No 1 (2023): Winter |
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| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/aacc.v9i1.11951 | |
| Keywords | ||
| postpartum hemorrhage triple pregnancy anesthesia multidisciplinary approach | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Kaya D, Çekmen N, Ayhan A. Perioperative Anesthesia Management of a Patient with Triplet Pregnancy Who Developed Hemorrhage Due to Uterine Atony during Cesarean Section: A Case Report. Arch Anesth & Crit Care. 2023;9(1):70-73.
