A woman was admitted in labor to the obstetrical unit at 11 PM. Her history and physical examination revealed no significant abnormalities. At the time of admission, she was having irregular contractions. In the delivery room, bleeding became extensive. A STAT hemoglobin, hematocrit, type and crossmatch for four units of blood, and coagulation profile were ordered. Laboratory Data Hemoglobin 10.0 g/L Hematocrit 27% Platelet count 75 × 109/L Bleeding time 10 minutes aPTT 65 seconds (control, 29 seconds) PT 19 seconds (control, 11 seconds) Thrombin time 24 seconds (normal, 18 to 22 seconds) Fibrinogen 90 mg/dL (normal, 200 to 400 mg/dL) FSP screen positive Protamine sulfate test positive Questions 1. What is the most probable cause of the extensive bleeding in this case? 2. What is the etiology of this disorder? 3. Will the transfusion of whole or fresh blood repress the bleeding?
A woman was admitted in labor to the obstetrical unit at 11 PM. Her history and physical examination revealed no significant abnormalities. At the time of admission, she was having irregular contractions. In the delivery room, bleeding became extensive. A STAT hemoglobin, hematocrit, type and crossmatch for four units of blood, and coagulation profile were ordered. Laboratory Data Hemoglobin 10.0 g/L Hematocrit 27% Platelet count 75 × 109/L Bleeding time 10 minutes aPTT 65 seconds (control, 29 seconds) PT 19 seconds (control, 11 seconds) Thrombin time 24 seconds (normal, 18 to 22 seconds) Fibrinogen 90 mg/dL (normal, 200 to 400 mg/dL) FSP screen positive Protamine sulfate test positive Questions 1. What is the most probable cause of the extensive bleeding in this case? 2. What is the etiology of this disorder? 3. Will the transfusion of whole or fresh blood repress the bleeding?
