Abstract
We investigated 12 patients who entered ICU after cesarean section due to bleeding and needed allogenic transfusions during a period from January 2005 to April 2008. The average age of the 12 subjects was 33 years. The 12 included 4 patients with placental abruption, 2 patients with uterine atony, 2 patients with placenta previa, 2 patients with placenta accreta, 1 patient with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and 1 patient with uterine rupture. Eight of the patients developed obstetric disseminated intravascular coagulation (DIC) as a complication. The average ICU stay period was 3 days, and the average hospitalization period was 20 days. All patients were successfully discharged from the hospital. The average transfusion volume of red cell concentrates, fresh frozen plasma, and platelet concentrates was 18, 15, and 18 U, respectively. Seven patients required hemostasis. Three patients received only transcatheter arterial embolization (TAE), 2 patients received only total hysterectomy, 1 patient received emergency total hysterectomy due to hemorrhagic shock during TAE, and 1 patient received TAE due to continuous bleeding after total hysterectomy. Establishment of a cooperative system among obstetricians, ICU physicians, anesthesiologists, and radiologists in addition to a system for emergent blood transfusion is recommended.
