Transoesophageal Doppler-guided fluid management in massive obstetric haemorrhage

Int J Obstet Anesth. 2014 Feb;23(1):71-4. doi: 10.1016/j.ijoa.2013.07.001. Epub 2013 Dec 5.

Abstract

Massive postpartum haemorrhage is a major worldwide cause of maternal mortality. Management requires intensive fluid resuscitation and blood transfusion. Although fluid therapy is often directed by the results of a full blood count and clotting screen, recent technological advances allow monitoring of haemodynamic function and cardiac output. Transoesophageal Doppler technology has been used during haemorrhagic shock in non-obstetric patients. We present the case of a caesarean delivery complicated by massive haemorrhage where transoesophageal Doppler monitoring with the CardioQ-ODM™ was used to guide fluid therapy and the use of vasoactive drugs.

Keywords: Cardiac output; CardioQ-ODM™; Obstetric haemorrhage; Transoesophageal Doppler velocimetry.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Platelets
  • Cardiac Output / physiology
  • Cesarean Section
  • Colloids / therapeutic use
  • Crystalloid Solutions
  • Erythrocytes
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Isotonic Solutions / therapeutic use
  • Postpartum Hemorrhage / therapy*
  • Pregnancy
  • Ultrasonography, Doppler / methods*
  • Ultrasonography, Interventional / methods*

Substances

  • Colloids
  • Crystalloid Solutions
  • Isotonic Solutions