Post Partum Hemorrhage SUPP Flashcards
What are the 4 T’s that can cause PPH?
Tissue, thrombus, tone, and trauma
Tissue: complete detachment and expulsion of the placenta is required to enable… what?
To enable adequate uterine contractions and blood vessel occlusion
Delayed spontaneous expulsion of the placenta or incomplete delivery of the placenta results in…
Parts of the placenta being retained inside the uterine cavity after delivery
What is the consequence of retained placental tissue?
Retained tissue prevents the uterine wall from fully contracting sealing off maternal blood vessels and results in PPH
Thrombus: fibrin depositions are located at the placental attachment site and at the occlusion of the placenta supplying vessels. This is critical to limit what?
Post partum bleeding
Placental abruption causes damage to ____ and pre eclampsia causes widespread ______ damage
Fetoplacental tissue ; endothelial damage
Damage to the fetoplacental tissue and widespread endothelial damage causes excessive exposure to ________ factor present in the _____________________
Tissue factor; placental vascular bed
Excessive exposure of tissue factor results in…
- disseminated intravascular coagulation which causes a depletion of thrombin
What is von williebrand disease?
A pre existing maternal coagulopathy condition
Depletion of thrombin causes an elevation in what blood tests?
INR, PTT, and PT which is indicative of impaired maternal coagulation
Tone: the blood supply to the placenta passes through…
The myometrium and is normally occluded as the uterine muscle fibers contract after delivery
What are factors that can cause a decrease in uterine muscle tone which results in decreased or weakened contractions (My Pregnant Mom Ate Pickles Regularly)
- multiple pregnancies
- poly- hydraminose
- macrosomy
- anesthetic applied during labour
- prolonged labour
- rapid labour
What is Cephalo-pelvic disproportion?
The fetal head and shoulder is wider than the birth canal
Cephalo-pelvic disproportion results in…
Prolonged second stage of labour
