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A Traumatic Cesarean Delivery with Consumptive Coagulopathy

  • Thomas L. Archer
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Abstract

A 39 year-old-woman, G5P1122 (L-1), is admitted to Labor & Delivery at 38 + 2/7 weeks estimated gestational age for induction of labor because of chronic hypertension and a current blood pressure (BP) of 137/94 (L-2). Other than her BP, the patient’s vital signs on admission are unremarkable and her weight and height are 76.5 kg and 160 cm, for a BMI of 30. The patient has not been taking any medications during pregnancy, has felt well, and reports frequent fetal movement. She denies headache, right upper quadrant pain, or visual changes (L-3), and her blood work on admission shows the following: WBC 10.5, Hgb 12.8, Hct 40.9, platelets 145K, BUN 7 mg/dL, and creatinine 0.7 mg/dL. Her uric acid and ALT are normal and her AST is only slightly elevated (L-4). There is a trace of protein in her urine and the urine toxicology screen is negative (L-5). The patient has delivered both of her living children vaginally and a vaginal delivery is anticipated for this pregnancy.

Reference

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    Rattray DD, O’Connell CM, Baskett TF. Acute disseminated intravascular coagulation in obstetrics: a tertiary centre population review (1980 to 2009). J Obstet Gynaecol Can. 2012;34(4):341–7.CrossRefGoogle Scholar
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    Resnik R, Lockwood C, Moore T, Greene M, Copel J, Silver R. Creasy & Resnik’s Maternal- Fetal medicine. 8th ed. Philadelphia: Elsevier, Inc.; 2019, pp. 574–8. Used with permission.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Thomas L. Archer
    • 1
  1. 1.Department of Anesthesiology 2008–2015University of California San Diego School of MedicineSan DiegoUSA

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