Massive intra operative bloodloss require sex pectant measures, efficient coordination among providers, and timely feedback to optimize outcomes. In the Philippines, case reports on massive blood loss and transfusion are lacking. This report describes a 67-year-old female who underwent elective adrenalectomy, nephrectomy, and hepaticresection, with a total intraoperative blood loss of 20 liters in a 13-hour surgery. Efficient conduct of the institution's massive transfusion protocol, multiple press or support, electrolyte and glucose correction, and anticipatory management of associated complications of hypovolemia and transfusion were important elements to successful management. The patient tolerated the surgery and was discharged well after 12 days. In theabsence of more sophisticated monitoring and management options in a low-resource setting, maximizing available means and anticipatory interventions is key.
Hemorrhage

Background. Newborn screening (NBS) is a procedure for the immediate detection of genetic, metabolic, and endocrine disorders in neonates and is crucial for prompt treatment should such disorders be identified. In the Philippines, Republic Act 9288 requires health workers to properly inform mothers regarding NBS and its importance before the procedure.

Objective. To determine the knowledge, attitude, and awareness of primiparous postpartum mothers towards NBS Methods: A survey questionnaire was administered to primiparous mothers from Wards 15 and 16 of the Philippine General Hospital from April 11 through May 14, 2017. Results of primiparous postpartum mothers with or without previous prenatal check-ups were then compared.

Results. We surveyed 160 mothers, with half (56.3%) aged between 20 and 29 years. There were 149 mothers with and 11 without prenatal checkups. Mothers with previous prenatal checkups were more likely to be aware of NBS than those without prenatal checkups. Knowledge on NBS of mothers with previous prenatal checkups was higher on average compared to those without previous prenatal checkups. There was no significant difference in attitude between mothers with or without prenatal checkups.

Conclusion. Prenatal checkups increased the awareness and knowledge of primiparous mothers' towards NBS, and thus can be a potent vehicle where healthcare providers may inform the mother on the process and purpose of this procedure.

Neonatal Screening ; Knowledge ; Awareness ; Attitude