A Case Report of Timely Interventions in Postpartum Hemorrhage: The Role of Real-Time Surveillance, Uncrossmatched Blood Products, and Aortic Compression

A 41-year-old G2P1 underwent a vaginal delivery complicated by a retained placenta, uterine atony, and a massive postpartum hemorrhage of 4000 mL. Despite hypotension, care was not escalated, possibly due to the absence of tachycardia, pallor, or mental status changes. While maternal early warning criteria failed to trigger an alert, an electronic real-time surveillance platform activated a team response. The patient became unresponsive with a systolic blood pressure of 47 mm Hg and severe hypoxemia. Aortic compression restored consciousness. She was resuscitated with uncrossmatched blood and never-frozen plasma. Rotational thromboelastometry showed preserved coagulation. Automated alerts and rapid intervention were lifesaving.