Questions and Answers
What is the first step in managing postpartum hemorrhage due to uterine atony?
Which of the following is a contraindicated second-line uterotonic agent for patients with asthma?
What should be administered after uterine massage and high-dose oxytocin for postpartum hemorrhage?
What is the purpose of intrauterine balloon tamponade in the management of postpartum hemorrhage?
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Which condition must be considered when using methylergonovine for postpartum hemorrhage?
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Study Notes
Management of Postpartum Hemorrhage Due to Uterine Atony
- Postpartum hemorrhage is defined as estimated blood loss of 2,000 mL or more, or any bleeding accompanied by hypovolemia.
- Uterine atony presents with a soft, boggy uterus, indicating the need for immediate intervention.
Step-by-Step Management
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Step 1: Uterine Massage & Oxytocin
- Initiate uterine massage to stimulate contraction.
- Administer high-dose oxytocin to promote uterine tone.
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Step 2: Tranexamic Acid
- Utilize tranexamic acid to aid in reducing blood loss through antifibrinolytic action.
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Step 3: Second-Line Uterotonic Agents
- Methylergonovine: Effective uterotonic but contraindicated in patients with hypertension.
- Carboprost Tromethamine: Another uterotonic option, contraindicated in individuals with asthma.
- Misoprostol: Can be used as a uterotonic agent with various routes of administration.
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Step 4: Intrauterine Balloon Tamponade
- Implement an intrauterine balloon tamponade as a mechanical method to control bleeding.
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Step 5: Laparotomy
- Consider laparotomy in cases where bleeding remains uncontrolled after all conservative measures have been attempted.
Contraindications
- Methylergonovine and carboprost tromethamine have specific contraindications that must be addressed before administration.
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Description
This quiz covers the management steps for postpartum hemorrhage due to uterine atony. It includes essential interventions such as uterine massage, pharmacological treatments, and surgical options. Test your knowledge on the appropriate actions and contraindications.
