Complications of Labor and Delivery

Question 1

Retain Placenta Pharmacologic interventions:

Answer 1

IV nitroglycerin given to relax the uterus, BP monitored—hypotensive—trendelenburg
Intraumbilical injection of a solution of oxytocin in saline

Question 2

Postpartum Hemorrhage

Answer 2

excessive bleeding that results in pt Sx of lightheadedness, vertigo or syncope and/or signs of hypovolemia
Etiologies:
Uterine atony
Trauma
Coagulation defects: congenital & acquired

Question 3

PPH Management

Answer 3

Fundal massage
IV access: for fluid and blood
Uterotonic drugs:
Oxytocin (Ptosin)
Methylergonovine IM (including directly into myometrium) if no HTN, Raynaud’s or scleroderma
Carboprost tromethamine (Hemabate) if no asthma
Misoprostol: optimum dose & route unclear