PPH

Question 1

Causes of primary PPH

Answer 1

1- Atony
2- Coagulopathy
3- Adherent placenta (eg, accreta)
4- Retained POCs
5- Lacerations
6- Inversion

Question 2

Causes of secondary PPH

Answer 2

1- Subinvolution
2- Coagulopathy
3- Retained POCs
4- Infection

Question 3

what kind of prostaglandin is cytotec?

Answer 3

E1

Question 4

what kind of prostaglandin is hemabate?

Answer 4

F2a, (carboprost)

Question 5

Risk factors for atony?

Answer 5

1- prolonged labor, 
2-induction of labor, 
3- prolonged use of oxytocin, 
4- chorioamnionitis, 
5- multiple gestation, 
6- polyhydramnios, and 
7- uterine leiomyomas

Question 6

Definition of PPH?

Answer 6

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]

Question 7

of prior CS with Previa indicates what risk for Accreta?

Answer 7

1 = 3%
2 = 11%
3 = 40%
4 = 61%
5 = 67%

Question 8

5 US features of Abnormally adherent placenta?

Answer 8

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

Question 9

Mortality of Accreta?

Answer 9

With C-Hyst: 2-7%

With conservative management: 30%

Question 10

Definition of “massive transfusion”?

Answer 10

> or equal to 10 U PRBC in 24 hrs OR

> or equal to 4 U PRBC in 1 hour

Question 11

In Massive Transfusion, what are the ratios and products?

Answer 11

1:1:1 of
FFP:Platelets:RBC