title: [Case Report: Recurrent postpartum haemorrhage after emergency caesarean section - Clipping, embolization and haemostaseological therapy].
abstract: Immediately after emergency caesarean section a 37 yr old patient suffered severe atonic bleeding requiring different operating procedures (Clipping of the uterine arteries) in combination with an uterotonic and haemostaseological medication as well as massive transfusion of blood components and recombinant factor VIIa. After a period of 17 days without any bleeding the patient presented to the emergency room with recurrent massive uterine bleeding. Transarterial embolization of the anterior bundles of the iliac arteries in combination with a second uterotonic and haemostaseological medication stopped the haemorrhage. Reasons and risk factors of a recurrent postpartum bleeding are discussed and a multidisciplinary algorithm for treatment is proposed.
authors.affiliation: Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum und Charité Campus Mitte, Berlin.
authors.forename: Lutz
authors.initials: L
authors.lastname: Kaufner
authors.forename: Martin
authors.initials: M
authors.lastname: Schuster
authors.forename: Markus
authors.initials: M
authors.lastname: Vogt
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kröncke
authors.forename: Christian
authors.initials: C
authors.lastname: von Heymann
mesh_terms: D000328:Adult; D000465:Algorithms; D001803:Blood Transfusion; D002585:Cesarean Section / Q000009:adverse effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D004632:Emergency Medical Services; D015942:Factor VIIa / Q000627:therapeutic use; D005260:Female; D006487:Hemostasis; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery / Q000628:therapy*; D006473:Postpartum Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use; D012307:Risk Factors; D014593:Uterine Inertia
chemical_list: D011994:Recombinant Proteins; D015942:Factor VIIa