“ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage
A case of massive post-partum hemorrhage in East-Malaysia, associated with 3-4 methylene-dioxy-methamphetamine (MDMA) abuse otherwise known as Ecstasy or locally as “ICE”, injected by the patient as a means to suppress labor pains prior to hospital presentation. We report a rare case of substance ab...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Bali Journal of Anesthesiology |
| Subjects: | |
| Online Access: | http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2017;volume=1;issue=2;spage=35;epage=38;aulast=Gill;type=0 |
| _version_ | 1819155585431502848 |
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| author | Navkiran Singh Gill Cheow Jaan Perng Alice Vong Liew Norhuzaimah Bt Julai Julaihi |
| author_facet | Navkiran Singh Gill Cheow Jaan Perng Alice Vong Liew Norhuzaimah Bt Julai Julaihi |
| author_sort | Navkiran Singh Gill |
| collection | DOAJ |
| description | A case of massive post-partum hemorrhage in East-Malaysia, associated with 3-4 methylene-dioxy-methamphetamine (MDMA) abuse otherwise known as Ecstasy or locally as “ICE”, injected by the patient as a means to suppress labor pains prior to hospital presentation. We report a rare case of substance abuse that lead to life threatening hemorrhage in a maternal patient of productive age group. Presenting to the labor suite in second stage of labor in breech presentation, exhibiting active neuropsychiatric symptoms of intoxication like euphoria, drowsiness, mydriasis but able to obey commands. A rapid response by the Obstetric on-call team proceeded with an assisted-breech delivery. Post-delivery, a baby girl with poor Apgar score was born and intubated. The mother was then posted for an Examination Under Anesthesia as she was noted to have slow blood oozing per-vaginally using a single shot spinal as she exhibited features of difficult intubation and high risk of aspiration. During the procedure, she tipped into massive PPH complicated with DIVC, and was rushed into the intensive care unit for stabilization and back into the operation theatre, needing a total abdominal hysterectomy (TAH) as definitive bleeding control. She required large scale resuscitative efforts peri-operatively including continuous veno-venous hemofiltration (CVVH) as well as regional intensive care consultation. We describe, chronologically the anesthetic challenges faced in managing a patient in acute substance intoxication at presentation to our district hospital during twilight hours. We then explain the pharmacodynamics of MDMA in provoking coagulopathy. No reports of similar cases in the South-East Asia region. |
| first_indexed | 2024-12-22T15:39:19Z |
| format | Article |
| id | doaj.art-ae48ccf2209a4bf98da7b563d25713f8 |
| institution | Directory Open Access Journal |
| issn | 2549-2276 |
| language | English |
| last_indexed | 2024-12-22T15:39:19Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Bali Journal of Anesthesiology |
| spelling | doaj.art-ae48ccf2209a4bf98da7b563d25713f82022-12-21T18:21:11ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762017-01-0112353810.15562/bjoa.v1i2.129“ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhageNavkiran Singh GillCheow Jaan PerngAlice Vong LiewNorhuzaimah Bt Julai JulaihiA case of massive post-partum hemorrhage in East-Malaysia, associated with 3-4 methylene-dioxy-methamphetamine (MDMA) abuse otherwise known as Ecstasy or locally as “ICE”, injected by the patient as a means to suppress labor pains prior to hospital presentation. We report a rare case of substance abuse that lead to life threatening hemorrhage in a maternal patient of productive age group. Presenting to the labor suite in second stage of labor in breech presentation, exhibiting active neuropsychiatric symptoms of intoxication like euphoria, drowsiness, mydriasis but able to obey commands. A rapid response by the Obstetric on-call team proceeded with an assisted-breech delivery. Post-delivery, a baby girl with poor Apgar score was born and intubated. The mother was then posted for an Examination Under Anesthesia as she was noted to have slow blood oozing per-vaginally using a single shot spinal as she exhibited features of difficult intubation and high risk of aspiration. During the procedure, she tipped into massive PPH complicated with DIVC, and was rushed into the intensive care unit for stabilization and back into the operation theatre, needing a total abdominal hysterectomy (TAH) as definitive bleeding control. She required large scale resuscitative efforts peri-operatively including continuous veno-venous hemofiltration (CVVH) as well as regional intensive care consultation. We describe, chronologically the anesthetic challenges faced in managing a patient in acute substance intoxication at presentation to our district hospital during twilight hours. We then explain the pharmacodynamics of MDMA in provoking coagulopathy. No reports of similar cases in the South-East Asia region.http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2017;volume=1;issue=2;spage=35;epage=38;aulast=Gill;type=0methamphetamineintoxicationpost-partum hemorrhagedisseminated intravascular coagulationcoagulopathy |
| spellingShingle | Navkiran Singh Gill Cheow Jaan Perng Alice Vong Liew Norhuzaimah Bt Julai Julaihi “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage Bali Journal of Anesthesiology methamphetamine intoxication post-partum hemorrhage disseminated intravascular coagulation coagulopathy |
| title | “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage |
| title_full | “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage |
| title_fullStr | “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage |
| title_full_unstemmed | “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage |
| title_short | “ICE” – A rare cause for coagulopathy in a case of massive post-partum hemorrhage |
| title_sort | ice a rare cause for coagulopathy in a case of massive post partum hemorrhage |
| topic | methamphetamine intoxication post-partum hemorrhage disseminated intravascular coagulation coagulopathy |
| url | http://www.bjoaonline.com/article.asp?issn=2549-2276;year=2017;volume=1;issue=2;spage=35;epage=38;aulast=Gill;type=0 |
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