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- Mar 12, 2005
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Speaking from the OB side. Was there a discussion of a likely accreta in this situation? A patient with 3 prior C/Ds and a current previa has a fairly high likelihood of having a placenta accreta and although they are picked up often by U/S, no imaging test is perfect.
This would lead into the additional IV placement and having blood products available and like others have echoed having the massive transfusion protocol ready to go. Another thought is potentially having a cell saver available which again would require advance notice.
The other issue would be where the case would be done. I would probably be more likely to do this case in the main OR rather than in a L and D OR and have additional back up in the form of gyn onc.
The other option if interventional radiology was available would be for prophylactic uterine artery balloon catheters which have been shown to be fairly effective.
I would have a low threshold for a hysterectomy in this situation.
The main thing with this case is the need for a lot of advanced planning. It's hard to gauge whether this was adequately done in this scenario because this surgery requires a lot of cross coordination with anesthesia, OB, and the transfusion service.
The
MOST IMPORTANT PART OF YOUR POST,
DR. OB/GYN DOCTOR,
is that despite your academic posts, in
THE REAL WORLD,
YOU. Yeah, YOU
HAFFTA MAKE A DECISION
CDAZY FAST
LIFE OR DEATH MAN
There are only a few
OB ROKKSTARRS
out there.
THAT WOULD'VE PREVENTED
THIS DEBACLE OF
PRBCS/FFP.....
Sorry man.
THE TRUTH HURTS.
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