Postpartum Haemorrhage Following Unsupervised Labour: The Role of the Anaesthetist

Obstetric haemorrhage is a leading cause of maternal morbidity and mortality and sometimes the patients require anaesthesia in the course of treatment. A Para 3 Nigerian who delivered outside the hospital was rushed in to the hospital in a shocked state following a major obstetric haemorrhage. She was immediately resuscitated and general anaesthesia administered for hysterectomy. Anaesthesia was induced with ketamine, intubation facilitated with suxamethonium and muscle relaxation maintained with 5 mg of atracurium while oxygen was administered. She received blood transfusion and the postoperative period was uneventful. There is need for emergency obstetric and anaesthetic services in developing and low income countries. There is need for continuous training in the administration of emergency anaesthesia to help reduce maternal morbidity and mortality. It is also necessary for blood bank services and antibiotics to be readily available.