Sangrado masivo en obstetricia. Estrategias de  tratamiento

Karina Rando; Martin  Mojoli

doi:10.35954/SM2017.36.2.7

Autores/as

Karina Rando Centro Nacional Hepato-Bilio-Pancreático. Dpto. de Anestesia. Hospital Central de las Fuerzas Armadas https://orcid.org/0000-0001-7397-1711
Martin Mojoli Departamento de Ginecología y Obstetricia. Hospital Central de las Fuerzas Armadas https://orcid.org/0000-0002-2418-3775

DOI:

https://doi.org/10.35954/SM2017.36.2.7

Palabras clave:

Anestesia; Hemorragia; Hemorragia Posparto; Placenta previa; Transfusión Sanguínea

Resumen

La pérdida sanguínea esperada es de hasta 500 ml en el parto natural y de 1000 ml en el parto por cesárea. La pérdida de sangre masiva en obstetricia es aquella que requiere transfusión de hemoderivados, necesidad de histerectomía o de otros procedimientos de emergencia
como la ligadura vascular para detener la pérdida de sangre y es una causa importante de morbilidad y de mortalidad del binomio madre-hijo.
Describimos el caso clínico de una gestante portadora de placenta previa, cesareáda que presentó un sangrado en dos etapas. En la primera se realizó el control quirúrgico del daño tisular y en la segunda se debió estabilizar y reanimar a la paciente antes de realizar la hemostasia
quirúrgica.
Marcamos las diferencias en la estrategia de reposición en relación al tipo de hemorragia. Se analizaron los factores favorecedores del sangrado y la importancia de la comunicación para lograr un buen resultado materno y fetal.

Recibido: Abril 2017
Aceptado: Agosto 2017

Correspondencia: : 8 de Octubre 3020. C.P. 11600, Montevideo, Uruguay. Tel.: (+598)24876666 int. 8185.
E-mail de contacto: Karina.rando@gmail.com

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