Postpartum haemorrhage Flashcards
Define postpartum haemorrhage.
Blood loss after pregnancy, major haemorrhage is defined as loss of >1L.
What is the aetiology of postpartum haemorrhage? What are risk factors for postpartum haemorrhage?
Uterine atony - This is the most common cause of PPH
Uterine inversion
Uterine rupture
Placental abruption
Placenta accreta, placenta increta or placenta percreta
Placenta previa
Retained placenta
Tearing
Failure to progress
Other conditions
von Willebrand Disease, DIC
Infection e.g. chorioamnionitis
Intrahepatic cholestasis of pregnancy
Obesity
Preeclampsia
Summarise the epidemiology of postpartum haemorrhage.
It usually happens within 1 day of giving birth, but it can happen up to 12 weeks after having a baby.
1-5% have PPH.
What are signs and symptoms of postpartum haemorrhage?
Heavy PV bleeding
Hypotension or signs of shock
Nausea and vomiting
Pale skin
Pain around the vagina or perineum
What are some investigations for postpartum haemorrhage?
Basic obs
Clinical diagnosis
FBC + Hematocrit
Blood loss measurement
Pelvic exam
Physical exam
USS
What is the management for postpartum haemorrhage?
IV fluids/blood
Hysterectomy or laparotomy
Massaging the uterus by hand
Oxygen
Embolisation of the blood vessels that supply the uterus
Iron
What are complications associated with postpartum haemorrhage?
Sheehan’s syndrome
Shock
Maternal death
Asherman’s syndrome
Prognosis depends on treatment and efficiency of diagnosis