Post Partum Haemorrhage

Question 1

Define Primary Post Partum Haemorrhage

Answer 1

Blood loss of 500ml or more in the first 24 hours post vaginal delivery.

Question 2

4 ts in post partum haemorrhage

Answer 2

Tone - check fungus
Trauma - repair/ stop trauma
Tissue - is there retained tissue
Thrombin - replace thrombin - clotting factors

Question 3

Assessment of blood volume state in PPH

Late sign and trends - 3

Answer 3

BP drop is a very late sign

Trends:

Perfusion of limbs,
Heart rate
Pulse rate

Question 4

Treatment of PPH - 3

clinical support level - when

Last resort

Answer 4

Fundal check +- massage until contraction is felt

Fluids - empty bladder. - radial pulse and cerebral perfusion

Pain relief

> 500ml - Medstar

Last resort - External aortic compression