Universal Journal of Public Health Vol. 5(6), pp. 312 - 314
DOI: 10.13189/ujph.2017.050604
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A Case Report on Life Threatening Hemorrhage in Preterm Pregnancy with Placenta Praevia and Management Challenges in a Low Neonatal Resourced Regional Hospital 187 km away from a Tertiary Center


Ayesha Akhter 1,*, Bruno Giorgio 1, Adebayo Adeyemi 1, Md Rafiqul Islam 1,2
1 Goulburn Valley Health, Australia
2 Department of Rural Health, the University of Melbourne, Australia

ABSTRACT

Placenta praevia is one of the obstetric emergencies, which can cause life threatening hemorrhage. Time interval to access support for these patients from emergency retrieval team are often challenging. Also, dilemmas may appear on taking decision for in-utero versus ex-utero transfer of neonates to tertiary hospital. In this case study, the patient presented with a life threatening antepartum hemorrhage (APH) in a low neonatal resourced regional hospital at 29 weeks of gestation. She was extremely needle phobic that delayed the resuscitation process. The overall situation and the patient's clinical condition were inappropriate for road transfer. Moreover, considering the weather condition on the day, air ambulance was grounded. Eventually, in-utero transfer of the neonate to tertiary hospital was impossible. As a result, she was delivered by an uncomplicated caesarean section and an initial resuscitation of the newborn was provided by the pediatric team of the hospital. Emergency neonatal retrieval team was able to arrive 3 hours after the birth for transferring the premature neonate to a tertiary center.

KEYWORDS
Life Threatening APH, Low Neonatal Resourced Hospital, Transfer Difficulties, Decision Dilemmas

Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] Ayesha Akhter , Bruno Giorgio , Adebayo Adeyemi , Md Rafiqul Islam , "A Case Report on Life Threatening Hemorrhage in Preterm Pregnancy with Placenta Praevia and Management Challenges in a Low Neonatal Resourced Regional Hospital 187 km away from a Tertiary Center," Universal Journal of Public Health, Vol. 5, No. 6, pp. 312 - 314, 2017. DOI: 10.13189/ujph.2017.050604.

(b). APA Format:
Ayesha Akhter , Bruno Giorgio , Adebayo Adeyemi , Md Rafiqul Islam (2017). A Case Report on Life Threatening Hemorrhage in Preterm Pregnancy with Placenta Praevia and Management Challenges in a Low Neonatal Resourced Regional Hospital 187 km away from a Tertiary Center. Universal Journal of Public Health, 5(6), 312 - 314. DOI: 10.13189/ujph.2017.050604.