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CP2 OBGYN > PostPartum Problems > Flashcards

PostPartum Problems Flashcards

1
Q

What is the average loss of blood after labour?

A

300ml

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2
Q

How does the body stop alot of blood loss after labour?

A

SM contraction

Woman in hypercoagulable state

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3
Q

Define PPH

A

Vaginal bleeding >500ml

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4
Q

What is 1’ PPH

A

From delivery the baby up to 24hr later

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5
Q

What is 2’ PPH

A

Within 6 weeks of delivery

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6
Q

What is uterine inversion and why does it happen?

A

When uterus starts to come out of pelvis/detaches from wall

Midwife pulls uterus out too much after delivery in attempt to deliver placenta

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7
Q

What are the 4 types of 1’PPH

A

Tone/Atony
Trauma
Tissue
Thrombin

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8
Q

What % of primary PPH are due to atony?

A

90%

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9
Q

Risk factors atonic PPH (9)

A 
Multiple pregnancy 
Grand multiparity 
Polyhydramnios 
Fibroid uterus 
Prolonged labour, induced labour 
Previous PPH 
APH 
Big baby 
Oesophageal atresia
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10
Q

Treatment atonic PPH

A 
Misoprostol 
Cintametrine 
Bakri balloon 
Uterine aa occlusion
Hysterectomy (last resort)
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11
Q

What is a 1’ tear?

A

Tear of perineal skin

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12
Q

What is a 2’ tear?

A

Tear into perineal mm

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13
Q

What is a 3’ tear?

A

Tears through anal sphincter –> loss of bowel fct

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14
Q

What is a 4’ tear?

A

Tears into anal sphincter + rectum

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15
Q

Causes of PPH tears

A

Big babies
Malposition
Forceps delivery
Long labour

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16
Q

Tx PPH tears

A

Repair in delivery under LA

17
Q

What is a succenturirate lobe?

A

extra lobe of placenta that can sometimes cause a PPH

18
Q

Secondary causes of PPH

A

Lochia
Infection e.g. endometriosis
Retained product - placenta

19
Q

Tx 2’ PPH

A

AB

Empty out womb

20
Q

How to examine a Pt w/ 1’PPH

A 
A-E 
AMount of blood lost 
Urine output 
Uterine contraction 
Fundal height 
Placenta + membranes complete 
Genital tract trauma
21
Q

How to examine a pt w// 2’PPH

A

Basic obs
h fundus
Speculum
Bimanual - size uterus

22
Q

What would tachyC, pyrexia and uterine tenderness indicate?

A

Endometriosis

23
Q

Investigations of 1’PPH

A

Bloods - clotting, placelets, haem, G+S + cross match

U/E if urine output poor

24
Q

Investigations of 2’PPH

A

FBC - WCC to excl infection

USS

25
Q

How to calculate maternal mortality ratio

A

Maternal mortality ratio = no’ deaths /100,000 maternities (births after 24 weeks of gestation)

26
Q

What % of women w/ puerperal psychosis have a pre-existing psych Hx

A

30%

27
Q

By having a CSC, how much does your risk of getting placenta acreta increase?

A

40%

28
Q

4 drugs to give to a woman haemorrhaging after pregnancy

A

Oxytocin
Ergometrine
Haemovate
Misoprostol

CP2 OBGYN (21 decks)

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