PPH Flashcards
Causes of primary PPH
1- Atony 2- Coagulopathy 3- Adherent placenta (eg, accreta) 4- Retained POCs 5- Lacerations 6- Inversion
Causes of secondary PPH
1- Subinvolution
2- Coagulopathy
3- Retained POCs
4- Infection
what kind of prostaglandin is cytotec?
E1
what kind of prostaglandin is hemabate?
F2a, (carboprost)
Risk factors for atony?
1- prolonged labor, 2-induction of labor, 3- prolonged use of oxytocin, 4- chorioamnionitis, 5- multiple gestation, 6- polyhydramnios, and 7- uterine leiomyomas
Definition of PPH?
EBL > or equal to 1,000 mL or accompanied by signs or symptoms of hypovolemia within 24 hours after the birth process (includes intrapartum loss) regardless of route of delivery
[EBL greater than 500 mL in SVD should be considered abnormal and should serve as indication to investigate]
of prior CS with Previa indicates what risk for Accreta?
1 = 3% 2 = 11% 3 = 40% 4 = 61% 5 = 67%
5 US features of Abnormally adherent placenta?
1- Absence of the hypoechoic retroplacental zone
2- Multiple Venous Lacunae (highest sensitivity)
3- Thin retroplacental myometrium
4- Placenta protrudes into bladder
5- Increased vascularity between uterus and bladder
Mortality of Accreta?
With C-Hyst: 2-7%
With conservative management: 30%
Definition of “massive transfusion”?
> or equal to 10 U PRBC in 24 hrs OR
> or equal to 4 U PRBC in 1 hour
In Massive Transfusion, what are the ratios and products?
1:1:1 of
FFP:Platelets:RBC