MATERNAL NEAR-MISS –A CASE REPORT ON SUCCESSFUL MANAGEMENT OF INTRACTABLE ATONIC POST PARTUM HEMORRHAGE

Abstract

Introduction :- Maternal near-miss refers to situations , where women experience severe life- threatening obstetric complications during pregnancy, delivery or post pregnancy, which they survive either by chance or because they receive good care at health facility. Cases of near-miss occur in larger numbers than maternal deaths. It has been estimated that up to 9 million women survive obstetric complications every year, and the consequences of these may be permanent and wide-reaching. Excessive hemorrhage during pregnancy or childbirth and severe hypertensive disorders contribute to large number of cases that result in to serious maternal morbidity. Case Report:- We present a case of a young primipara ,who reported to hospital in a condition of hemorrhagic shock with history of cardiac arrest before admission. She had intractable atonic postpartum hemorrhage, following full term vaginal delivery in private nursing home. She was resuscitated and operated for emergency obstetric hysterectomy with bilateral internal iliac ligation. She developed disseminated intravascular coagulation, which was treated by aggressive blood and component therapy. She went home in a hemodynamic ally stable condition. Conclusion:- Every obstetrician should intelligently anticipate and keep oneself prepared to tackle the problem of intractable postpartum hemorrhage. Prompt and aggressive management of post partum hemorrhage will save many young lives. A saying ‘ Delay means death holds true for such emergency situation.