title: Lifesaving intraosseous access in a patient with a massive obstetric hemorrhage.
abstract: A 42-year-old, gravida 1, para 0 woman was induced at a gestational age of 41 weeks because of post-term dates. The fourth stage of delivery was complicated by a massive hemorrhage. The uncontrollable persisting amount of blood loss led to hypovolemic shock and cardiopulmonary arrest. Lifesaving extra access was gained through an intraosseous needle in the proximal tibia. We therefore advocate including the use of an intraosseous needle as an additional route for intravascular volume replacement in case of peripartum hemorrhage.
authors.affiliation: Department of Obstetrics and Gynecology, Amphia Hospital Breda, Breda, The Netherlands.
authors.forename: Joey
authors.initials: J
authors.lastname: de Vogel
authors.forename: Roger
authors.initials: R
authors.lastname: Heydanus
authors.forename: Annemarie G M
authors.initials: AG
authors.lastname: Mulders
authors.forename: Dina J C
authors.initials: DJ
authors.lastname: Smalbraak
authors.forename: Dimitri N M
authors.initials: DN
authors.lastname: Papatsonis
authors.forename: Bastiaan M
authors.initials: BM
authors.lastname: Gerritse
keywords: Intraosseous infusion; hypovolemic shock; massive obstetric hemorrhage; peripartum