PPH Flashcards
What is the first vital sign change that will be seen with a PPH?
Heart rate will increase
What percentage of maternal deaths are die to severe bleeding?
25%
What percentage of deaths related to PPH are preventable?
54-93%
How many women experience PPH?
1 in 20
How much does maternal plasma volume expand during pregnancy?
42%
What is the RBC increase for a pregnant woman?
24%
Why are women who have a hx of hypertension at a higher risk for PPH?
they have a diminished maternal plasma volume expansion
When will women begin to show signs of hypovolemic shock during a PPH?
After 1/3 of her blood volume is lost
What is a frequent clinical error that causes late diagnosis of PPH?
not drawing Hct and Hgb levels soon enough
What is the average blood loss for a vaginal delivery, cesarean delivery, elective cesarean hysterectomy, and an emergency hysterectomy, respectively?
Spontaneous vaginal delivery: 10% (500mL)
Cesarean delivery: 25% (1,000mL)
Elective cesarean hysterectomy: 33% (1,500mL)
Emergency hysterectomies: up to 75% (3,500mL)
During a vaginal birth, what are reasons that the mother may experience the same amount of blood loss as a cesarean?
use of instruments (forceps, vacuum, or episiotomy) as well as having a 3rd or 4th degree laceration
What percentage of NSVD and C/S, respectively, have a PPH?
4% and 6%
When is primary PPH and when is secondary PPH?
less than 24 hours after delivery and after 24 hours after delivery
What is the most common cause of PPH?
uterine atony
What is the most common reason that uterine atony occurs?
Bladder distention
What kind of drugs should be avoided in hypertensive women?
ergot alkaloids
When should prostaglandins be contraindicated in a pregnant woman?
if a woman has reactive airway disease
What are the drugs ordered when PPH is identified?
Oxytocin (Uterotonic), Methylergovine (uterotonic), Carboprost (Uterotonic), Dinoprostone, Misoprostol (prostaglandins)
When would a slow trickle of blood be seen when a mother is postpartum?
if the mother has a laceration
3 ways to manage stage the third stage of labor
20 units oxytocin, fundal massage, and gentle cord traction
What are two uterotonics that are used to manage the third stage of labor?
Pitocin and carboprost
How much blood is lost during a PPH?
> 1000mL or 10% total blood loss
