Post-Partum Haemorrhage (PPH)

Question 1

what is PPH?

Answer 1

blood loss of 500ml or more after the birth of the baby

Question 2

classification of PPH

Answer 2

primary

secondary

Question 3

what is primary PPH?

Answer 3

within 24 hours of delivery

Question 4

what is secondary PPH?

Answer 4

> 24 hours - 6 weeks post-delivery

Question 5

causes

Answer 5

4 T's
tone
trauma
tissue
thrombin

Question 6

how to prevent PPH?

Answer 6

active management of 3rd stage with syntocinon/syntometrine IM/IV

Question 7

management of PPH

Answer 7

• uterine massage
• syntocinon
• interventional radiology
• surgical

Question 8

management if continued PPH

Answer 8

ergometrine 
carboprost/haemabate
misoprostol PR
tranexamic acid
hydrostatic balloons
tissue sealant

Question 9

when to avoid ergometrine?

Answer 9

cardiac disease

hypertension

Question 10

interventional radiology option

Answer 10

arterial embolisation

Question 11

surgical options for PPH

Answer 11

ligation

hysterectomy

Question 12

3 examples of abnormal labour presentations

Answer 12

breech
transverse
hyperextension

Question 13

what is the breech position?

Answer 13

feet first

can be complete, footling or frank

Question 14

what is the transverse position?

Answer 14

shoulder or arm can descend first

Question 15

what is the hyperextension presentation?

Answer 15

can be brow or face presentation