Postpartum hemorrhage Flashcards
1
Q
Definition of PPH (including Primary vs Secondary)
A
- PPH: blood loss >500ml from genital tract after delivery
- Primary PPH: within 24 hours after delivery
- Secondary PPH: more than 24 hours till 6 weeks post-delivery
2
Q
Causes of primary vs secondary PPH
A
> Primary (4T’s)
- Tone: uterine atony
- Tissue: retained placenta
- Trauma
- Thrombin
> Secondary
- Retained POC
- Endometritis
- Placenta site trophoblastic tumor
3
Q
Management of postpartum hemorrhage
A
- Assess ABC + Vital sign
- Insert 2 large bore cannulas
- Take blood (FBC, PT/ APTT, GXM)
- Set up IV drip for IV fluid, IV oxytocin
- Massage uterus
- Repeat oxytocin/ syntometrine
- If still bleeding -> IM carboprost
- Still bleeding -> intrauterine balloon tamponade, bakri balloon, Foley catheter
- If tone problem -> surgery (eg: uterine artery ligation, hysterectomy)
4
Q
Definition of retained placenta
A
- Failure of placental delivery within 30minutes after the delivery of the fetus
5
Q
Prevention of uterine inversion
A
- Controlled cord traction - avoid excessive traction
- Wait for sign of placental separation
- NO fundal pressure
