Producido el alumbramiento espontáneo, a los 10 minutos del parto eutócico, mientras se encontraba la paciente en la sala de observación del referido Centro de Salud Bellavista Nanay, la paciente presenta sangrado vaginal profuso, por lo que se aplica: masaje uterino y administración de oxitocina endovenoso. En vista que la paciente continua con sangrado severo deciden transferir de urgencia al Hospital Regional de Loreto, siendo la 1 de la mañana del día 13 de Julio del 2014. Al examen clínico al ingreso al Hospital Regional de Loreto se encuentra: presión arterial 80/40 mmHg; pulso 122 por min.; Glasgow 15/15; palidez acentuada de la piel y mucosas; abdomen blando y depresible; útero no contraído; al tacto vaginal abundante coágulos y sangre en cavidad vaginal con chorro continuo. Se aplica medidas para estabilizar hemodinàmicamente a la paciente; se solicita exámenes de l...

Bleeding occurring in the second half of pregnancy causes important maternal and infant morbidity and even mortality; at the Instituto Nacional Materno Perinatal it compromises between 9 and 15% of all gestations. We recall it is associated to premature delivery, abruption placenta, placenta previa, disseminated intravascular coagulation. Treatment frequently requires blood and blood derivates transfusions as well as performing surgical procedures, including emergency hysterectomy. This is a review of second half of pregnancy hemorrhage causes; we emphasize precocious diagnosis and timely treatment of these pathologies.

Bleeding occurring in the second half of pregnancy causes important maternal and infant morbidity and even mortality; at the Instituto Nacional Materno Perinatal it compromises between 9 and 15% of all gestations. We recall it is associated to premature delivery, abruption placenta, placenta previa, disseminated intravascular coagulation. Treatment frequently requires blood and blood derivates transfusions as well as performing surgical procedures, including emergency hysterectomy. This is a review of second half of pregnancy hemorrhage causes; we emphasize precocious diagnosis and timely treatment of these pathologies.

The author analyzes the criteria with which it has faced in his clinic consecutive acute syndrome fibrinogenopenia the box "placental abruption". Considers that addressed the causes of the decline in the levels of fibrinogen, is justified today than ever before proceeding to the early artificial rupture of membranes (medical birth Kreis) in order to trigger the job and also interfere with the release of tromboplásticas or fibrinolytic substances simultaneously and closely watching the changes taking place in the test and the clot fibrinogenemia curve. When treatment does not work obstetric results or blood incoagulability syndrome is emerging from a severe beginning with characters, I think that should be used without delay to the evacuation of the uterus by Cesarean section. Specific treatment of hypo- and afibrinogenaemia should include the timely administration - using the intravenou...

The author analyzes the criteria with which it has faced in his clinic consecutive acute syndrome fibrinogenopenia the box "placental abruption". Considers that addressed the causes of the decline in the levels of fibrinogen, is justified today than ever before proceeding to the early artificial rupture of membranes (medical birth Kreis) in order to trigger the job and also interfere with the release of tromboplásticas or fibrinolytic substances simultaneously and closely watching the changes taking place in the test and the clot fibrinogenemia curve. When treatment does not work obstetric results or blood incoagulability syndrome is emerging from a severe beginning with characters, I think that should be used without delay to the evacuation of the uterus by Cesarean section. Specific treatment of hypo- and afibrinogenaemia should include the timely administration - using the intravenou...