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OB > OB PPH > Flashcards

OB PPH Flashcards

1
Q

Contraindication to Methergine

A

HTN

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2
Q

Repeat interval of Methergine

Total repeat doses

A

2 hours
(In practice most will repeat after 15 minutes)

No max amount

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3
Q

Hemabate

  1. Dosage
  2. Repeat interval
  3. Total repeat doses
  4. Contraindication
  5. Class of drug
A
  1. 250 micrograms
  2. 15 mins
  3. 8 doses
  4. Asthma
  5. PGf alpha
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4
Q

Dose of cytotec for PPH

A

1 mg

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5
Q

PRBC

  1. Volume
  2. Effect on hgb
  3. Effect on hct
A
  1. 250 cc
  2. Hgb inc by 1
  3. Hct incr 3%
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6
Q

Plt

  1. Volume
  2. Content
  3. Effect
A
  1. 50cc
  2. 50 mil plt
  3. Rises 5-10,000
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7
Q

FFP

  1. Volume
  2. Content
  3. Effect
A
  1. 250cc
  2. 200mg Fib, fac V, VIII, antithrombin III
  3. Until fibrinogen >100, or normal PT
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8
Q

Cryoprecipitate

  1. Volume
  2. Content
  3. Effect
  4. Dose
A
  1. 25 cc
  2. 200 mg Fib, fac VIII, XIII, von Willebrand
    factor
  3. Until Fib >100, normal PT
  4. 1u/5-10 kg wt
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9
Q

Rate of crystalloid repletion per EBL

A

3cc crystalloid/1cc EBL

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10
Q

Definition of Massive Transfusion Protocol

A

replacement of >50% of blood volume in 12-24 hours

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11
Q

O’Leary Stitch

A

Uterine artery ligation

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12
Q

B-lynch stitch placement

A

3cm below incision

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13
Q

Warfarin

  1. Mechanism of Action
  2. Placental Transfer
  3. Teratogenic
  4. Labs for monitoring
  5. Clinical Aim
  6. Dose
  7. Antidote
  8. Side Effects
  9. Half-life
A
  1. Factors 2, 7, 9, 10
  2. Yes
  3. Yes
  4. PT, INR
  5. 2-3.0
  6. Variable
  7. Vit K
  8. Fetal bleeding, Fetal Coumadin Synd (1TM- stippled epiphyses, limb+nasal hypoplasia, 2TM- optic atrophy + microcephaly)
  9. 4 hours
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14
Q

Heparin

  1. Mechanism of Action
  2. Placental Transfer
  3. Teratogenic
  4. Labs for monitoring
  5. Clinical Aim
  6. Dose
  7. Antidote
  8. Side Effects
  9. Half-life
A
  1. Co-factor for Antithrombin Xa
    Increases inhibition of thrombin & Factor Xa
  2. No
  3. No
  4. PTT
  5. 1.5-2.0
  6. 1000 u/hr or 6000 u Q6 hr (proph 5000 u BID)
  7. Protamine sulfate (1mg/100u Heparin) Max 15mg/15 min
  8. Maternal thrombocytopenia , osteoporosis (both w/ long term use)
  9. 1.5 hrs
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15
Q

LMWH (Enoxaparin)

  1. MOA
  2. Monitoring
  3. Advantages
  4. Disadvantages
  5. Placental Transfer
A
  1. Inhibits factor Xa (better than reg heparin)
  2. only w/ therapeutic anticoag- anti-Xa Q4-6 wks
    (obtain 4 hrs after dosing)
  3. Longer half life (once or twice daily dosing), dec risk of thrombocytopenia, osteoporosis, post-op bleeding
  4. cost, inc risk of epidural hematoma (wait >12 hrs w/ prophylactic dosing for epidural and > 24 hrs w/ therapeutic dosing), contraind in preg w/ prosthetic valves
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16
Q

Changes in clotting system in normal pregnancy

A
  1. incr fac 5, 7, 9, 10, 12 & fibrinogen

2. inc plasminogen activator inhibitor type I & II (inhibits plasminogen activator

OB (5 decks)

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