Postpartum haemorrhage Flashcards

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1
Q

PPH definition

A

Blood loss of >500ml after a vaginal delivery

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2
Q

Primary PPH

A

Within 24 hours

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3
Q

Secondary PPH

A

Between 24 hours and 6 weeks

Typically due to retained placental tissue or endometritis

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4
Q

Causes of PPH

A

Tone (uterine atony)- vast majority

Trauma (perineal tear)

Tissue (retained placenta)

Thrombin (clotting/ bleeding disorder)

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5
Q

Risk factors

A

Previous PPH

Prolonged labour

Pre-eclampsia

Increased maternal age

Polyhydramnios

Emergency C section

Placenta praevia/ accreta

Macrosomia

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6
Q

Management

A

Immediate senior involvement

A-E approach
- 2 peripheral cannulae
- lie flat
- bloods (including G&S)
- warmed crystalloid infusion

Palpate uterus and catheterise

IV oxytocin, ergometrine, carboprost (unless asthma)

Surgery

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7
Q

Surgery

A

Intrauterine balloon tamponade first line where uterine atony is only or main cause

B-lynch suture, ligation of uterine arteries or internal iliac arteries

Hysterectomy

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8
Q

Classification of blood loss

A

Minor <1000ml

Major (moderate) 1000-2000ml

Major (severe) >2000ml

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