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Massive atonic bleeding during cesarean delivery in a patient with chronic idiopathic intestinal pseudo‐obstruction: A case report and literature review
Author(s) -
Katayama Yoshihiro,
Kido Saki,
Kai Shotaro,
Nakano Takahiro,
Hidaka Nobuhiro,
Kato Kiyoko
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14363
Subject(s) - medicine , uterine atony , atony , pregnancy , intestinal pseudo obstruction , surgery , obstetrics , hysterectomy , genetics , biology
A 35‐year‐old primigravid woman with chronic idiopathic intestinal pseudo‐obstruction presented to our institution. Except for an enlarged fetal bladder, her pregnancy was almost uneventful until she developed pre‐eclampsia requiring emergent cesarean section at 34 weeks gestation. After delivery, intractable uterine atony developed with blood loss reaching 3500 mL within 15 min. Following a B‐Lynch suture, the bleeding attenuated but uterine atony persisted; lochia persisted for 3 months post‐partum. The infant was diagnosed with megacystis microcolon intestinal hypoperistalsis syndrome after birth. The mother's clinical course and previous reports suggested that atonic bleeding was associated with the pathology of chronic idiopathic intestinal pseudo‐obstruction; the infant's disease was considered to be maternal‐related disease. Clinicians should be vigilant in pregnant patients with chronic idiopathic intestinal pseudo‐obstruction especially with these complications.