April 2007 · Vol. 19, No. 04Postpartum hemorrhage:
Solutions to 2 intractable cases
A stepwise approach to bleeding caused by persistent uterine atony and placental abnormalities
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Fast Track
Recombinant factor VIIa can help control hemorrhage even in the presence of dilutional or consumptive coagulopathy
Radiographic embolization of the uterine artery is best suited to cases of slow but continuing blood loss
If only a small area of the placenta is firmly adherent to the uterus, an attempt to remove or excise it is reasonable
When placenta percreta involves the bladder, retention of the placenta may be the only safe option
Each unit of packed red blood cells increases the hematocrit by about 3% and raises the hemoglobin level by about 1 g
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Michael
L.
Stitely,
MDAssistant Professor, Department of Obstetrics and Gynecology, West Virginia University School of Medicine, Morgantown, WVa Robert
B.
Gherman,
MDDirector of Maternal–Fetal Medicine, Prince George’s Hospital Center, Cheverly, Md
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