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So its all about index of suspicion, which should be extremely high in a case like this. Ive taken people back to the OR in exactly this situation with arterial pH < 7 and other significant metabolic derangements because the obstetricians just werent anticipating the severity. you might be surprised at how well these patients may do until they fall to ****, like mentating and talking to you with nonpalpable BP and severe acidemia. unfortunately, hypoperfusion, hypothermia, acidosis all feed the fire of whatever coagulopathy is brewing, and if you arent keyed into the possibilities, this patient goes south very quickly.
so, in response, i dont just care about a patient appearing stable in PACU, especially not this patient. ortho patients can bleed, plastics patients can bleed, hell some hearts can bleed, but i do not like to see D+Cs bleed.
edit: ESPECIALLY not when fetal demise is involved (as opposed to simply retained placenta from live birth)
so, in response, i dont just care about a patient appearing stable in PACU, especially not this patient. ortho patients can bleed, plastics patients can bleed, hell some hearts can bleed, but i do not like to see D+Cs bleed.
edit: ESPECIALLY not when fetal demise is involved (as opposed to simply retained placenta from live birth)
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