Obs postnatal care Flashcards
What is post partum haemorrhage?
The loss of 500ml or more blood from the genital tract within 24hrs of the birth of a baby
What is secondary post partum haemorrhage?
Bleeding between 24hrs and 12 weeks post birth
How can secondary post partum haemorrhage be further classified?
- Minor - 500-100ml
- Major - >1000ml
What are the 4 causes of primary post partum haemorrhage?
- Tone - uterine atony
- Trauma - perineal tear
- Tissue - retained placenta
- Thrombin - pre-exsisting or acquired coagulopathy
What is primary post partum haemorrhage?
Bleeding within 24 hrs of birth
What are two causes of secondary post partum haemorrhage?
- Endometriosis
- Retained products of conception
Give the first 5 stages of management uterine atony
- Uterine massage
- Bolus of oxytocin/ergometrine/both
- Oxytocin infusion
- Repeat ergometrine dose
- IM carboprost
Why is oxytocin given in PPH?
It helps the uterus contract
Why is ergometrine given in PPH?
It causes vasoconstriction of blood vessels
What is carboprost and why is it given in PPH?
A synthetic prostaglandin that causes uterine contraction
What are the 3 types of 3rd degree tear?
- 3A - <50% of external anal sphincter
- 3B - >50% of external anal sphincter
- 3C - external and internal sphincters affected
What degree of tears require repair in theatre?
3rd and 4th degree tears
Would would indicate postpartum LMWH for 6 weeks?
- Previous VTE
- Antenatal LMWH
- High risk thrombophilia
- Low risk thrombophilia + FHx
Would would indicate postpartum LMWH for 10 days?
- CS
- BMI >40
- Admission >3 days
- Any surgical procedure
- Medical co-morbidities
What birth weight indicates fetal macrosomia?
> 4500g
