Stopping Massive, Uncontrollable Uterine Bleeding Post-Caesarean Section: A Case Report

This case report is about a 43 year old patient in Poland who had been pregnant 6 times previously and they all ended in spontaneous abortions prior to 20 weeks. She had been trying for 15 years to become pregnant. She was never given any reasons for the 6 spontaneous abortions by various doctors except she was told “It happens”. This “explanation” sounded very unusual to us. No tests were ever performed on her or her husband and naturally when she stopped trying, she got pregnant. This 7thpregnancy was relatively uneventful except for some hyperemesis gravidarum that started around the 30thweek and the fact that she was high risk due to her advanced age, however, again, no one ever supposedly told her this. She received no special care being such a high risk patient, nor would she tell us who her OB/GYN was, which is very unusual as in Poland, during pregnancies, all visits throughout the 40 weeks and delivery results are documented in a book that is given to the patient at the start of the pregnancy. She had no such book and could not explain herself. According to this patient, she was in excellent condition and reported being thin and working out on a regular basis prior to becoming pregnant. She came into the maternity hospital emergency room “feeling strange”. We checked her in the Emergency Room because the nurse couldn’t believe the blood pressure reading she was getting. She was found to have a blood pressure of 200/130 and a pulse of 60, tachypnoea at 40; an obvious case of massive shock and preeclampsia - but why? Also, why such severe bradycardia?? Why this had never been discovered by her primary OB/GYN at her weekly visits is a mystery to her and to us (we suspected no prenatal care, ever), but this was the time to act, not to debate as to why this was happening while the patient died. We also suspected that the patient had been lying to us all along, that she never had any hospital care at all and that simply she had a midwife with each previous pregnancy. It seemed like she just did not want to admit to us the embarrassment of her multiple mistakes.