International journal of obstetric anesthesia
-
Int J Obstet Anesth · Apr 2008
Acute normovolemic hemodilution, intraoperative cell salvage and PulseCO hemodynamic monitoring in a Jehovah's Witness with placenta percreta.
A Jehovah's Witness who had had four previous cesarean deliveries was referred to our institution for management of a complete placenta previa at 34 weeks of gestation. A subsequent ultrasound scan was suggestive of placenta percreta with bladder involvement. After erythropoietin and iron supplementation, cesarean hysterectomy was performed. ⋯ A bolus of oxytocin given after delivery produced profound hypotension, the hemodynamics of which were elucidated with the PulseCO system. To our knowledge, the combined use of acute normovolemic hemodilution, intraoperative cell salvage and PulseCO hemodynamic monitoring for cesarean hysterectomy has not been reported previously. These techniques may be particularly useful in managing patients who refuse blood products and/or in whom the baseline hemoglobin is suboptimal.
-
Int J Obstet Anesth · Apr 2008
Letter Case ReportsPosterior reversible encephalopathy syndrome (PRES).