post-partem hemorrhage Flashcards
what is normal blood loss in pregnancy
500cc vaginal
1000cc C-section
Is mom anemic during pregnancy
Yes. Mom is anemic during pregnancy (technically) due to huge plasma increase
what is the overarching theme in post partem hemorrhage?
stop bleeding or take out uterus
how do we begin diagnosing postpartem hemorrhage?
look at the uterus
if uterus is absent, what has occurred?
uterine inversion
how do we solve uterine inversion
manually put back the uterus with hands, can use tocolytics to calm uterus then use uterine tonics
if uterus is boggy in the context of postpartem hemorrhage what has occurred?
uterine atony
how do we solve uterine atony?
massage the uterus. if you had pitocin going and stopped the pit, restart the pit so that the uterus will contract down and stop the post partem hemorrhage
If uterus is firm in the context of postpartem hemorrhage what has occurred?
retained placental products
how do we solve retained placental products?
have to go in for it. D and C or hysterectomy.
in the context of post partem hemorrhage if we find a normal uterus, what has occurred?
vaginal or cervical laceration.
rarely DIC.
in the context of post partem hemorrhage if we find a normal uterus and no vaginal or cervical lacerations what has occurred?
think DIC
what are all the treatments for uterine atony
1) uterine massage
2) oxcytocin (if used and turned off)
3) methergen or hemebate (PGE meds)
4) surgery (uterine artery ligation, embolization or hysterectomy)
what are all the treatments for uterine inversion
1) put back in place manually.
2) tocolytics to calm, then oxytocin to contract down and stop bleeding
what are all the treatments for vaginal lacerations?
1 hold pressure
2 suture
