Articles: placenta-previa-surgery.
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Asia Oceania J Obstet Gynaecol · Jun 1994
Case ReportsAutologous blood transfusion for the patient with placenta previa complicated by placenta increta: a case report.
The patient, who was 34 years of age, had previously had a transverse incision of the lower uterine segment cesarean section because of placenta previa. She was admitted to the hospital due to placenta previa again at 27 weeks of gestation in the current pregnancy. Ultrasound examination revealed placenta increta as well as placenta previa. ⋯ A cesarean hysterectomy was performed at 37 weeks of gestation because of placenta increta. Blood loss was estimated at 1,830 ml, and 1,500 ml of autologous blood was transfused. A leap-frog method of autologous blood collection for this pregnant woman with risk of massive hemorrhage was simple and beneficial, resulting in the preservation of more than 1,500 ml of autologous blood for transfusion.
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Patients on a busy obstetric service were prospectively evaluated to determine which ones required blood transfusion. During the period January-April 1990, 5,528 deliveries were performed. Fifty-five patients (0.99%) received blood transfusions during their pregnancy and puerperium. ⋯ The hemorrhage and subsequent need for a blood transfusion were not necessarily due to the procedure except in the case of trauma due to instrumental vaginal delivery. The rate of transfusion of red blood cells for patients undergoing vaginal instrumental delivery was significantly higher than the rate for those undergoing cesarean delivery (relative risk, 2.8; 95% confidence interval, 1.5-5.2). The need for transfusion can be anticipated on the basis of antepartum causes in only 23.7% of patients ultimately receiving blood products.