Multidisciplinary Escalation and Hemostatic Control in Refractory Postpartum Hemorrhage Following Cesarean Delivery
American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA
Abstract
A 32-year-old female developed severe postpartum hemorrhage following cesarean delivery, with an estimated blood loss >1500 mL and hemodynamic instability. Initial uterotonics and uterine massage were ineffective. Anesthesia rapidly escalated care with large-bore IV access, invasive monitoring, and activation of a massive transfusion protocol. Balanced resuscitation with blood products, vasopressors, and continued uterotonics was initiated. Hemostasis was unable to be achieved in OR and patient underwent uterine artery embolization guided by intervential radiology. This case highlights a stepwise, multidisciplinary approach to postpartum hemorrhage and reviews the mortality benefit of timely interventions.