Obs emergencies- 3rd stage complications Flashcards
1
Q
definition of PPH?
A
>500ml blood loss within 24h of delivery
2
Q
aetiology of PPH?
A
Tone –> uterine atony (most common)
Tissue –> retained tissue/placenta
Trauma–> perineal tears
Thrombin –> coagulopathy
3
Q
definition of secondary PPH and causes?
A
>500ml blood loss from 24h- 6 weeks post delivery
Causes:
- Endometritis
- Tear/Trauma
- Tissue
4
Q
presentation of PPH?
A
PV bleeding
5
Q
Mx of PPH?
A
ABCDE
if severe–> major haemorrhage protocol
6
Q
specific Mx for uterine atony?
A
- Syntocinon
other medical options:
- fundal massage
- prostaglandin analogue (carboporost, misoprostol)
- tranexamic acid
surgical options:
- compression suture
- balloon tamponade
- uterine a ligation
- hysterectomy
7
Q
prevention of PPH?
A
empty bladder as distension prevents uterine contraction
8
Q
outline the classification of perineal tears
A
- 1st degree
- skin only
- 2nd degree
- skin + perineal muscle
- 3rd degree
- above + anal sphincter
- 4th degree
- above + rectal mucosa
9
Q
Mx of perineal tears?
A
surgical repair
