The Unexpected  After the Delivery  Room 

Alexander Storm, Jacob Jones MD, Benjamin  Ludden

● Postpartum hemorrhage ≠ always uterine 

● PACU: hypotension + normal uterine tone 

● POCUS → fluid in splenorenal recess ● Hidden hemoperitoneum exposed 

Saving a Life, One System at a Time 

34yo s/p emergency cesarean Stable Uterus sudden hypotension  in PACU 

 

POCUS reveals hemoperitoneum  — bleeding hidden beyond the  uterus. 

Laparotomy  

and  

hysterectomy 

Anisocoria concerning for ICH VV-ECMO TRALI and hypoxemia 37 Units blood product

Lessons Beyond The Uterus 

● POCUS expands diagnostic scope 

● Life‑saving therapies carry risk 

● Balance resuscitation and anticoagulation 

● Continuous, coordinated reassessment 

In obstetric anesthesia, saving one life means managing many competing risks.