Massive obstetric haemorrhage following removal of a cervical suture.
The authors present an unusual case of massive ante partum haemorrhage following removal of a cervical suture. This patient was admitted for routine removal of a McDonald's cervical suture at 37 weeks gestation. The suture was densely adherent and after removal she suffered a haemorrhage of 2500 ml from where the suture was removed which led to fetal distress and an emergency caesarean section. The cervix was sutured and a vaginal pack inserted. During the procedure she developed hypovolaemic shock requiring 7 units of blood, 4 units of fresh frozen plasma, 1 unit of platelets and 1 unit of cryoprecipitate. Ten days later she was readmitted with a postpartum haemorrhage of 1000 ml requiring further haemostatic sutures to the cervix.
Department of Obstetrics and Gynaecology, St James's University Hospital, Leeds, UK. louisehowarth@doctors.org.uk
Louise Ann
LA
Howarth
Sarah
S
Sherliker
D000328:Adult; D001270:Cervical Atlas / Q000601:surgery*; D058734:Exsanguination / Q000209:etiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D013536:Suture Techniques / Q000009:adverse effects; D013537:Sutures / Q000009:adverse effects*; D002581:Uterine Cervical Incompetence / Q000601:surgery; D014592:Uterine Hemorrhage / Q000209:etiology*