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Massive Pontine Hemorrhage by Dual Injection of Autologous Blood

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Massive Post-Partum Haemorrhage In A SARS-Cov-2 Positive Primi Gravid Patient: A Case Report.

Ushna Ahmed¹, Nida Najmi¹, Rozilla Sadia Khan¹

¹Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, Pakistan.

JPMA. the Journal of the Pakistan Medical Association

|July 20, 2023

Summary

A severe case of postpartum hemorrhage occurred in a COVID-19 positive woman, necessitating a hysterectomy. This case highlights the potential increased risk of severe obstetric hemorrhage in COVID-19 patients.

Keywords:

Pregnancy, Covid-19, haemorrhage.

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Area of Science:

Obstetrics and Gynecology
Infectious Diseases
Critical Care Medicine

Background:

Primary postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide.
The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on obstetric complications, particularly PPH, remains under investigation.

Observation:

A 20-year-old, previously healthy, South Asian woman presented with severe PPH following a normal vaginal delivery.
The patient tested positive for SARS-CoV-2 upon admission.
Initial conservative management, including bilateral internal iliac artery ligation, failed to control the hemorrhage, leading to a life-saving hysterectomy and massive blood transfusion.

Findings:

This case suggests a potential association between SARS-CoV-2 infection and an increased susceptibility to massive postpartum hemorrhage.
COVID-19 positive obstetric patients may require earlier and more radical interventions for hemorrhage control.

Implications:

Further observational studies are crucial to establish a definitive link between COVID-19 infection and obstetric hemorrhage.
Healthcare providers should maintain a high index of suspicion for severe PPH in COVID-19 positive pregnant individuals.