Table 4 Audit summary of five selected case histories of patients with severe life-threatening postpartum hemorrhage treated by ecbolics and the B-Lynch brace suture application in the period 1989–1995 at Milton Keynes General Hospital, UK1


Age (years)



Parity



GA


Presenting
diagnosis


Mode of
delivery


Infant sex and weight (g)


Apgar score at
5 and 10 min



Type of PPH


Treatment and ­volume transfused


Intensive care admission



Outcome


28

PP

39/40

placental abruption, PPH, DIC

spontaneous vertex

male (2800)

4, 7

primary

ecbolics,
20 units fresh blood, 8 units FFP

48 h; full antibiotic cover

good; 3 years later spontaneous vertex delivery; female (3890 g); no problems

22

PP

43/40

prolonged
labor,
persisting occipito position?, cephalopelvic disproportion

emergency
CS

male (4190)

7, 10

primary

ecbolics,
13 units blood,
5 units packed cells, BSA

48 h; full antibiotic cover

good; normal CT pelvimetry 2 years later; elective CS at 39 weeks; female (3820 g); no problems

23

PP (twin)

37/40

eclampsia in labor, PPH, DIC

emergency
CS

(1) female (2735),
(2) female (2430)

(1) 3, 8
(2) 5, 8

primary

ecbolics,
19 units blood,
5 units FFP,
BSA

72 h; full antibiotic cover

good; no complications

35

PP (IVF)

38/40

major
placenta
previa

elective
CS

female (3370)

9, 10

secondary,
9th day readmission

ecbolics,
15 units blood,
5 units FFP,
BSA

72 h; full antibiotic cover

good; no complications

30

PP

40/40

uterine atony

spontaneous vertex

female (3890)

9, 10

primary

ecbolics,
15 units blood,
7 units packed cells, BSA

48 h; full antibiotic cover

good; no complications


PP, primiparous; GA, gestational age in weeks; PPH, postpartum hemorrhage; CS, Cesarean section; CT, computerized tomography; DIC, disseminated intravascular coagulations; BSA, brace suture application; IVF, in vitro fertilization; FFP, fresh frozen plasma