Week 9 - PPH Flashcards
what is the definition of a post party haemorrhage?
blood loss of > 500 mis form the birth canal from the end of second stage to 24 hours post birth
what are some contributing factors to PPH?
large baby polyhydraneous multiparit retained third stage difficult labour prolonged labour full bladder infection APH pre-eclampsia drugs operative delivery
what are the four ts for post party hemmorage?
thrombin
tissue
tone
trauma
what is tone for PPH?
tone
- relaxed uterus
most common 70%
what is tissue for PPH?
retained placenta tissue
10%
what is trauma for PPH?
perineal/vaginal tears
20%
thrombin cause for PPH?
clotting problems - DIC
1%
what are the general signs of PPH?
enlarged uterus - boggy visible bleeding resltessness/pallor tachycardia - increase by 20bmp hypotension - drops by 20mmHg vital sings not reflective of loss maternal collapse
what is the general management for PPH?
position- autoinfusion not recommended- elevate feet on pillows but keep pelvis flat
monitor
14-16 g cannula
IV therapy
consult PIPER
notify and transport to hospital
what is the management for a PPH?
PIPER?MICA?CONSULT reducing anxiety O2 IV find cause
what to do if tone is the cause of PPH?
encourage mum to empty bladder
encourage breast feeding
fundal massage until firm
what are the degrees or perineal trauma?
1- superficial involves skin
2- slightly larger some muscle involvement
3- larger involves muscle and anal sphincter
4- involves anal sphincter and recall mucosa
what is a secondary post party haemorrhage?
abnormal bleeding from 24 hours to 6 weeks post delivery
caused by infection, retained placenta
what are the types of blood loss post labour?
lochia rubra- 1-3 days red blood loss
lochia serosa 4-10 days lighter red to brown
lochia alba 11- 21 days brown to clear
