Caesarean section in a patient with coagulopathy


  • D.S. Мityuryev Municipal Institution of Lviv Regional Council “Lviv Regional Perinatal Center”, Lviv, Ukraine Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • I.M. Koshova Municipal Institution of Lviv Regional Council “Lviv Regional Perinatal Center”, Lviv, Ukraine
  • O.A. Loskutov Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine



anemia, cesarean section, obstetric hemorrhage, intensive treatment of bleeding


The work deals with the study of intensive care of women in labor with massive obstetric hemorrhage. Using their own experience with caesarean section in a patient with a coagulopathy (platelet level initially reduced to 34 × 109/l), the authors consider various approaches to the management of these patients, analyze current approaches to the treatment of massive obstetric hemorrhages, and provide protocols for intensive treatment of such complications.


Rajashree Chavan, M Y Latoo. Recent advances in the management of major obstetric haemorrhage. BJMP 2013;6(1):a604.

GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1545-1602. doi: 10.1016/S0140-6736(16)31678-6.

Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Еt al.Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010 May 8;375(9726):1609-23. doi: 10.1016/S0140-6736(10)60518-1.

Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (Eds.). Saving Lives, Improving Mothers’ Care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2014.ISBN 978-0-9931267-1-0.

Collis R, Guasch E. Managing major obstetric haemorrhage: Pharmacotherapy and transfusion. Best Pract Res Clin Anaesthesiol. 2017 Mar;31(1):107-124. doi: 10.1016/j.bpa.2017.02.001.

Moodley J1, Pattinson RC, Fawcus S, Schoon MG, Moran N, Shweni PM; National Committee on Confidential Enquiries into Maternal Deaths in South Africa. The Confidential Enquiry into Maternal Deaths in South Africa: a case study. BJOG. 2014 Sep;121 Suppl 4:53-60. doi: 10.1111/1471-0528.12869.

Anjan Trikha, Preet Mohinder Singh. Management of major obstetric haemorrhage. Indian J Anaesth. 2018 Sep; 62(9): 698–703. doi: 10.4103/ija.IJA_448_18.

Kozek-Langenecker SA, Ahmed AB, Afshari A, Albaladejo P, Aldecoa C, Barauskas G, De Robertis E, Et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: First update 2016. Eur J Anaesthesiol. 2017 Jun;34(6):332-395. doi: 10.1097/EJA.0000000000000630.

Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage. WHO Department of Reproductive Health and Research. [Last accessed on 2018 Jul 12]. Available from:

British Committee for Standards in Haematology, Stainsby D, MacLennan S, Thomas D, Isaac J, Hamilton PJ. Guidelines on the management of massive blood loss. Br J Haematol. 2006 Dec;135(5):634-41.doi: 10.1111/j.1365-2141.2006.06355.x.

Levy D. Obstetric haemorrhage. In: Johnston I, Harrop-Griffiths W, Gemmell L, editors. AAGBI Core Topics in Anaesthesia. Chichester: Wiley-Blackwell Ltd.; 2012. ‒ pp. 105 - 123. Print ISBN:9780470658628 |Online ISBN:9781118227978 |DOI:10.1002/9781118227978.

Saule I, Hawkins N. Transfusion practice in major obstetric haemorrhage: lessons from trauma. Int J Obstet Anesth. 2012 Jan;21(1):79-83. doi: 10.1016/j.ijoa.2011.09.009.

Goucher H, Wong CA, Patel SK, Toledo P. Cell Salvage in Obstetrics.Anesth Analg. 2015 Aug;121(2):465-8. doi: 10.1213/ANE.0000000000000786.

Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. [No authors listed]. Anesthesiology. 2016 Feb;124(2):270-300. doi: 10.1097/ALN.0000000000000935.





Notes from Practice