A 29-year-old woman arrives at the hospital in labor at 38 weeks gestation of an otherwise uncomplicated second pregnancy. Her labor fails to progress after 20 hours; a cesarean se... A 29-year-old woman arrives at the hospital in labor at 38 weeks gestation of an otherwise uncomplicated second pregnancy. Her labor fails to progress after 20 hours; a cesarean section delivers a healthy female infant. A few minutes after the procedure, the patient begins to have heavy vaginal bleeding. Placental abruption is diagnosed and appropriately managed with fluid resuscitation and transfusion of 4 units of blood, yet she continues to have moderate bleeding (see lab results). Which of the following infusion is the most appropriate management? A. Cryoprecipitate B. Platelets C. Albumin D. Iron
Understand the Problem
The question presents a clinical scenario of a postpartum hemorrhage secondary to placental abruption that is not responding to initial management. The question requires the selection of the most appropriate infusion based on the limited information in the lab results. We need to consider which blood product will best address the patient's ongoing bleeding given the suspected underlying cause, as well as the limited lab results.
Answer
Cryoprecipitate.
The most appropriate management is cryoprecipitate.
Answer for screen readers
The most appropriate management is cryoprecipitate.
More Information
Cryoprecipitate is rich in fibrinogen, factor VIII, von Willebrand factor, and factor XIII. In the context of placental abruption and massive blood transfusion, the patient is at risk for dilutional coagulopathy and disseminated intravascular coagulation (DIC). Her lab results indicating decreased fibrinogen confirm this. Cryoprecipitate is used to increase fibrinogen levels, which is essential for clot formation and controlling bleeding.
Tips
A common mistake is to choose platelets, but platelets are more appropriate for thrombocytopenia (low platelet count) or platelet dysfunction, which is not the primary issue in this scenario. Albumin is a volume expander but does not address the underlying coagulopathy. Iron is used to treat iron deficiency anemia and is not relevant in an acute bleeding situation.
AI-generated content may contain errors. Please verify critical information
