{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:27:17Z","timestamp":1792290437509,"version":"4.4.0"},"reference-count":11,"publisher":"Pensoft Publishers","issue":"1","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Massive bleeding during obstetric surgeries, such as hysterectomy, is a significant cause of maternal mortality and morbidity worldwide. In such cases, fluid resuscitation is imperative. However, intraoperative guidelines and fluid requirements cannot be universally standardized to accommodate every patient, surgical procedure, or condition. The debate between restrictive and liberal fluid resuscitation during massive intraoperative bleeding has persisted for a long time. Both approaches have been associated with side effects that impact patient morbidity and mortality. Despite the fact that there have been extensive studies on fluid and hemodynamic optimization, results remain inconsistent due to the varying definitions of \u201crestrictive\u201d and \u201cliberal\u201d fluid management and the differing monitoring protocols across studies. The present study describes a case of a 28-year-old woman in her third pregnancy who was scheduled to undergo a cesarean section and hysterectomy due to placenta accreta. The patient experienced significant intraoperative bleeding, prompting the administration of substantial intravenous fluids and blood products to maintain hemodynamic stability. She was closely monitored for signs of fluid overload. The resuscitation efforts proved successful, and the patient was discharged without complications.<\/jats:p>","DOI":"10.3897\/folmed.67.e137668","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T12:41:13Z","timestamp":1740573673000},"source":"Crossref","is-referenced-by-count":1,"title":["Fluid resuscitation dilemma: anticipating massive blood loss in hysterectomy"],"prefix":"10.3897","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8444-1633","authenticated-orcid":true,"given":"I Wayan","family":"Suranadi","sequence":"first","affiliation":[{"name":"Universitas Udayana\/Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7840-1132","authenticated-orcid":true,"given":"I Gede Prima","family":"Julianto","sequence":"additional","affiliation":[{"name":"Universitas Udayana\/Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1437-8218","authenticated-orcid":true,"given":"Bianca","family":"Jeanne","sequence":"additional","affiliation":[{"name":"Universitas Udayana\/Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2258","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"137668_B1","doi-asserted-by":"crossref","unstructured":"1. Al-Ghamdi AA. Intraoperative fluid management: Past and future, where is the evidence? Saudi J Anaesth 2018; 12(2):311\u20137.","DOI":"10.4103\/sja.SJA_689_17"},{"key":"137668_B2","doi-asserted-by":"crossref","unstructured":"2. Della Rocca et al. Liberal or restricted fluid administration: are we ready for a proposal of a restricted intraoperative approach? BMC Anesthesiology 2014; 14:62.","DOI":"10.1186\/1471-2253-14-62"},{"key":"137668_B3","doi-asserted-by":"crossref","unstructured":"3. Miller TE, Myles PS. Perioperative fluid therapy for major surgery. Anesthesiology 2019; 130(5):825\u201332.","DOI":"10.1097\/ALN.0000000000002603"},{"key":"137668_B4","doi-asserted-by":"crossref","unstructured":"4. Myles PS, Bellomo R, Corcoran T, et al. Restrictive versus Liberal fluid therapy for major abdominal surgery. N Engl J Med 2018; 378:2263\u201374.","DOI":"10.1056\/NEJMoa1801601"},{"key":"137668_B5","doi-asserted-by":"crossref","unstructured":"5. Akinlaja O. Hematological changes in pregnancy - the preparation for intrapartum blood loss. Obstet Gynecol Int J 2016; 4(3):00109.","DOI":"10.15406\/ogij.2016.04.00109"},{"key":"137668_B6","doi-asserted-by":"crossref","unstructured":"6. Ekelund K, Hanke G, Stensballe J, et al. Hemostatic resuscitation in postpartum hemorrhage - a supplement to surgery. Acta Obstet Gynecol Scand 2015; 94(7):680\u201392.","DOI":"10.1111\/aogs.12607"},{"key":"137668_B7","doi-asserted-by":"crossref","unstructured":"7. Mavrides E, Allard S, Chandraharan E, et al. Prevention and management of postpartum haemorrhage. BJOG 2016; 124:e106\u2013e49.","DOI":"10.1111\/1471-0528.14178"},{"key":"137668_B8","doi-asserted-by":"crossref","unstructured":"8. Cotton BA GJ, Morris JA, Abrumrad NN. The cellular, metabolic and systemic consequences of aggressive fluid resuscitation strategies. Shock 2006; 26:115\u201321.","DOI":"10.1097\/01.shk.0000209564.84822.f2"},{"key":"137668_B9","doi-asserted-by":"crossref","unstructured":"9. Mittermayr MSW, Haas T, Fries D, et al. Effect of colloid and crystalloid solutions on endogenous activation of fibrinolysis and resistance of polymerized fibrin to recombinant tissue plasminogen activator added ex vivo. Br J Anaesth 2008; 100:307\u201314.","DOI":"10.1093\/bja\/aem363"},{"key":"137668_B10","doi-asserted-by":"crossref","unstructured":"10. De Lange N, Schol P, Lance M, et al. Restrictive Versus Massive Fluid Resuscitation Strategy (REFILL study), influence on blood loss and hemostatic parameters in obstetric hemorrhage: study protocol for a randomized controlled trial. Trials 2018; 19(1):166.","DOI":"10.1186\/s13063-018-2512-z"},{"key":"137668_B11","doi-asserted-by":"crossref","unstructured":"11. Schol PB, Terink IM, Lance MD, et al. Liberal or restrictive fluid management during elective surgery: a systematic review and meta-analysis. J Clin Anesth 2016; 35:26\u201339.","DOI":"10.1016\/j.jclinane.2016.07.010"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/137668\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/137668\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=137668&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T12:41:19Z","timestamp":1740573679000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/137668\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,26]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,2,26]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.67.e137668","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2,26]]},"article-number":"e137668"}}