Postpartum Haemorrhage Following Unsupervised Labour: The Role of the Anaesthetist

Abstract

Obstetric haemorrhage is a leading cause of maternal morbidity and mortality and sometimes the patients require anaesthesia in the course of treatment. A Para 3 Nigerian who delivered outside the hospital was rushed in to the hospital in a shocked state following a major obstetric haemorrhage. She was immediately resuscitated and general anaesthesia administered for hysterectomy. Anaesthesia was induced with ketamine, intubation facilitated with suxamethonium and muscle relaxation maintained with 5 mg of atracurium while oxygen was administered. She received blood transfusion and the postoperative period was uneventful. There is need for emergency obstetric and anaesthetic services in developing and low income countries. There is need for continuous training in the administration of emergency anaesthesia to help reduce maternal morbidity and mortality. It is also necessary for blood bank services and antibiotics to be readily available.

Share and Cite:

L. Ebirim, B. Lagiri and O. Buowari, "Postpartum Haemorrhage Following Unsupervised Labour: The Role of the Anaesthetist," Open Journal of Anesthesiology, Vol. 2 No. 5, 2012, pp. 202-204. doi: 10.4236/ojanes.2012.25046.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] E. Ogboli-Nwasor, “Third Trimester Obstetric Haemor-rhage: Still a Challenge,” League of Obstetric Anaesthetists of Nigeria Lectures and Maiden Lecture General Meeting, p. 7.
[2] A. C. Umezulike, “Maternal Mortality in Nigeria: The Present State and the Way Forward,” Nigerian Journal of General Practice, Vol. 7, No. 9, 2006, pp. 5-18.
[3] S. Badwin and M. Rucklidge, “Management of Obstetric Haemorrhage,” Update in Anaesthesia, Vol. 25, No. 2, 2009, pp. 42-46.
[4] B. Hunt, “Use of the Coagulation Laboratory and Near Patient Testing in Thrombosis and Bleeding in Obstetric Anaesthesia,” In: R. Fernando and C. Elton, Eds., Three-Day Course on Obstetric Anaesthesia and Analgesia, 2008, pp. 53-54.
[5] J. Drife, “Maternal Mortality,” In: D. M. Lueslay and P. N. Baker Eds., Gynaecology and Evidence-Based Text for MRCOG, Arnold Publishers, London, 2004, pp. 196-204.
[6] W. O. Chukwudebelu, “Preventing Maternal Mortality in Developing Countries,” In: A. Okonofua and K. Odunsi, Eds., Contemporary Obstetrics and Gynaecology for Developing Countries, Women’s Health and Action Research Centre, Benin, 2003, pp. 644-657.
[7] A. O. Arowojolu, “Managing Major Early (Primary) Postpartum Haemorrhage in Developing Countries,” Tropical Journal of Obstetrics and Gynaecology, Vol. 20, No. 2, 2003, pp. 144-152.
[8] S. Campbell and C. Lee, “Obstetric Emergencies,” In: S. Campbell and C. Lee, Eds., Obstetrics by Ten Teachers, 17th Edition, Arnold Publishers, London, 2000, pp. 303-317.
[9] C. Vicki, “Obstetric Haemorrhage,” In: R. Fernando and C. Elton, Eds., Three-Day Course on Obstetric Anaesthesia and Analgesia, 2008, pp. 46-52.
[10] D. A. B. Turner, “Emergency Anaesthesia,” In: A. R. Aitkenhead, G. Smith and D. J. Rowbotham, Eds., Text-book of Anaesthesia, 5th Edition, Churchill Livingstone Elsevier Publishers, London, 2007, pp. 540-553.
[11] N. Nusrat and A. S. Nisar, “Emergency Peripartum Hysterectomy: Frequency, Indications, and Maternal Out-come,” Journal of Ayub Medical College Abbottabad, Vol. 21, No. 1, 2009, pp. 48-51.
[12] S. E. Adaji, S. B. Bature and O. S. Shittu, “Unplanned Births before Arrival at the Hospital in a Low Resource Setting: A Case Setting,” Nigerian Medical Journal, Vol. 18, No. 4, 2009, pp. 431-433.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.