Obstetrics and gynecology
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Obstetrics and gynecology · Oct 1997
Case ReportsIntravenous iron therapy for severe pregnancy anemia with high erythropoietin levels.
To demonstrate that intravenous (IV) iron therapy rapidly can secure the physiologic correction of severe nonhemorrhagic anemia more safely than blood component therapy and recombinant erythropoietin treatment. ⋯ Intravenous iron administration rapidly corrected severe nonhemorrhagic anemia in a pregnant patient and may produce an improvement in fetal indices. High erythropoietin levels predict a good response to iron and may obviate the need for blood transfusions and recombinant erythropoietin administration, at least until this therapy is tried.
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To evaluate the etiology, management, and maternal and perinatal outcome in patients with septic shock during pregnancy. ⋯ In women with septic shock, progression to death can be dramatically rapid. Because vascular permeability is increased, it may be appropriate to administer vasopressors early during resuscitation. An initial low cardiac output is a poor prognostic sign.
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Obstetrics and gynecology · Oct 1997
Case ReportsNormovolemic hemodilution before cesarean hysterectomy for placenta percreta.
Placenta percreta can create life-threatening hemorrhage at the time of delivery. The additional challenge of patient refusal of blood transfusion for religious reasons requires the use of comprehensive blood-conserving strategies. ⋯ Acute normovolemic hemodilution can be used safely in the pregnant woman at high risk for excessive intraoperative blood loss and should be considered in obstetric patients who strictly adhere to religious convictions prohibiting the acceptance of blood products.