Postpartum Haemorrhage Flashcards
What is the definition of a Primary PPH?
500mL blood loss within 24 hours of birth
What are the 4 causes of a Primary PPH?
Tone
Trauma
Tissue
Thrombin
What is the definition of a Secondary PPH?
Excessive bleed between 24 hours and 12 weeks post birth
What is the primary cause of a Secondary PPH?
Uterine atony or subinvolution of the placental site secondary to retained products or infection
True or False. Carbetocin has a shorter half life than Oxytocin?
False. Carbetocin has a significantly longer half life and therefore has longer sustained uterine contractions
What is Tranexamic Acids MoA?
Antifibrinolytic haemostatic agent
- Displaces plasminogen from fibrin resulting in inhibition of fibrinolysis
Tranexamic acid is a synthetic derivative of lysine that exerts antifibrinolytic effects by blocking lysine binding sites on plasminogen molecules, inhibiting the interaction of plasminogen with formed plasmin and fibrin.
Within what time frame can we give TXA to a PPH?
Within 3 hours of childbirth
What is the universal care for a PPH?
Early transport
Temperature management
Assess external labia and perineum
Encourage to empty bladder
What is the minimum age for administering Carbetocin?
16
How much TXA do we give and how long is the push time?
1g over 2-3 minutes
In Primary PPH we use permissive hypotension to guide fluid administration. What are our clinical signs for giving fluid?
Not appropriately responding to verbal commands
OR
If they cant respond verbally then radial pulse
What is our fluid protocol in a Primary PPH?
IV Saline, 250mL aliquots up to 20mL/kg
Post a birth, What should we do if the haemorrhage is uncontrolled or patient deteriorates despite treatment?
External abdominal aortic compression
Protocol for Secondary PPH?
Saline, 250mL aliquots up to 20mL/kg till responding to verbal commands
Contact SAAS medical practitioner
