Ahead of print ID: ERMPS-11279

Shock caused by spontaneous rupture uterine vessels during puerperal period: a case report and literature review

H.-F. Wang, S.-R. Song, A.-H. Zhang, A.-L. Yao, Q. Liang

Obstetrics & Gynecology, Tianjin Third Central Hospital, Hedong District, Tianjin, China. whf16418@163.com

The spontaneous rupture of the uterine vessels during the puerperal period is a rare, mortal complication. The clinical presentation of the above state includes sudden abdominal pain, hypovolemic shock signs and drop in hemoglobin levels. The case of a 32-year-old woman (who delivered a baby girl after 39 weeks of pregnancy) is reported with sudden symptoms of shortness of breath, palpitation, sweating, nausea and small amount of vaginal bleeding after 10.20 hrs of delivery shock. Emergency laparotomy and emergency blood transfusion were given immediately. Intraoperative findings showed that the volume of intraperitoneal free blood and gore was about 3,500 ml, and the size of uterine was similar to that of 16 weeks pregnant women. The suture was given to the uterine vascular rupture for hemostasis after clearing up the hematocele and blood clot disseminated intravascular coagulation (DIC). Four units of fresh frozen plasma and 750 ml of autologous blood were transfused immediately, and other four units of PRBC were transfused after the surgery to prevent DIC.