PPH

Question 1

What is PPH?

Answer 1

1.blood loss of 500ml after vaginal delivery
2.1000ml after cesarean section
3. Blood loss significant enough to cause hemodynamic instability

Question 2

At what percentage of blood loss do we consider it life threatening?

Answer 2

40% of the blood (approximately 2800ml)

Question 3

How do we classify PPH?

Answer 3

1. Primary PPH
   Blood loss within 24hours after delivery
2. Secondary PPH
   Blood loss after 24hours to up to 12 weeks

Question 4

What are the primary and secondary causes of PPH?

Answer 4

Primary
Uterine atony
Retained placenta
Abruptio placenta
Extended tears
Placenta previa
Defects of coagulation
Secondary
Retained products of conception
Infection
Gestational Trophoblastic Disease

Question 5

What are the maternal risk factors?

Answer 5

Advanced maternal age
Primiparity
Grand multiparity
Previous caesarean
Bleeding disorders
Previous PPH
Obesity

Question 6

What are the fetal and inrisk factors?

Question 7

What is uterine atony?

Answer 7

-Failure of the uterus to contract after the delivery of the placenta (‘tone’),

Question 8

What are the risk factors of Uterine Atony and explain them?

Answer 8

1.Uterine Fatigue- Prolonged labour, Rapid labour, Induced labour,grand mutiparity)
2.Overdistention of the Uterus- (Macrosomia, Polyhydraminos, multiple gestation, fetal hydrocephalus)
3.Bladder distention
4.Drugs-tocolytics
5.Uterine Infection-
6.Adherent placenta- Acrreta Syndrome
7.Uterine Fibroids.