A 34-year-old patient, Sally Arbogast, underwent a vaginal delivery but experienced sharp abdominal pain and moderate bleeding right afterward. She had delivered her last child by a Cesarean section. The obstetrician who cared for her performed a manual exploration and curettage procedure to rule out uterine scar rupture and later diagnosed uterine atony — a loss of tone in the muscles in the uterus. It has been noted that 90% of all postpartum bleedings are associated with uterine atony, which is the failure of the uterine muscles to contract normally after the baby and placenta are delivered.
While the doctors were looking into the patient’s hypotension, she coded. After resuscitation measures and a blood transfusion, Arbogast received multiple units of packed blood cells and fresh frozen plasma over the next five hours.