PP hemorrhage - action Flashcards
What is postpartum hemorrhage (PPH)?
A serious and potentially life-threatening condition characterized by excessive bleeding following childbirth.
What is the definition of primary PPH?
Blood loss of more than 500 ml after a vaginal delivery or more than 1,000 ml after a cesarean section within the first 24 hours postpartum.
What is secondary PPH?
Occurs from 24 hours to 12 weeks postpartum.
What are the Four T’s that cause PPH?
- Tone: Uterine atony
- Tissue: Retained placental tissue or clots
- Trauma: Genital tract lacerations or incisions
- Thrombin: Coagulation disorders
What is the most common cause of PPH?
Uterine atony.
What is the first action to take when PPH is suspected?
Call for help and mobilize the obstetric and emergency response team.
What vital signs should be monitored in a PPH case?
- Blood pressure
- Heart rate
- Oxygen saturation
What immediate action should be taken if uterine atony is suspected?
Perform a bimanual uterine massage to stimulate uterine contraction.
What is the first-line medication for treating PPH?
Oxytocin, typically given intravenously.
What medication may be used if oxytocin is insufficient?
Methylergonovine (avoid in hypertensive patients).
What should be established for fluid and medication administration in PPH management?
Large-bore intravenous access.
What is the purpose of fluid resuscitation with crystalloids in PPH management?
To maintain blood volume and circulation.
What blood products may be prepared for transfusion in PPH cases?
- Packed red blood cells
- Fresh frozen plasma
- Platelets
What should be inspected to rule out retained tissue in PPH management?
The placenta for completeness.
What are some surgical interventions for persistent bleeding in PPH?
- Uterine tamponade
- Uterine artery embolization
- Surgical exploration and interventions (e.g., compression sutures, hysterectomy as a last resort)
