Postpartum Hemorrhage Overview

Primary PPH is defined as bleeding in excess of 500ml after vaginal delivery or 1000ml after cesarean section within the first 24 hours.

The four main causes are Tone (uterine tone), Tissue (retained tissue), Trauma (lacerations), and Thrombin (bleeding disorders).

Women with preexisting anemia have a decreased tolerance to blood loss compared to healthy women, who typically have an increased blood volume during pregnancy.

<p>Primary PPH accounts for 28% of pregnancy-related deaths worldwide.</p> Signup and view all the answers

<p>Prolonged or obstructed labor and over distention of the uterus, such as in polyhydramnios, can contribute to uterine atony.</p> Signup and view all the answers

<p>Primary PPH is a leading cause of maternal mortality, accounting for a significant portion of pregnancy-related deaths, especially in resource-limited settings.</p> Signup and view all the answers

<p>Retained tissue, such as placental fragments, can lead to prolonged bleeding and is crucial to assess and treat in cases of PPH.</p> Signup and view all the answers

<p>The estimated incidence of primary PPH ranges from 3.7% to 8.6%.</p> Signup and view all the answers

<p>Placenta accreta, placenta increta, and placenta percreta.</p> Signup and view all the answers

<p>DIC stands for disseminated intravascular coagulation and is associated with placental abruption and amniotic fluid embolism.</p> Signup and view all the answers

<p>Correction of anemia and active management of the third stage of labor.</p> Signup and view all the answers

<p>Oxytocin.</p> Signup and view all the answers

<p>It is used for gentle cord traction with uterine counter-traction when the uterus is well contracted.</p> Signup and view all the answers

<p>It should be given IM during the crowning of the fetal head.</p> Signup and view all the answers

<p>At least 2 peripheral infusion lines using a wide bore cannula.</p> Signup and view all the answers

<p>Grouping and cross-matching 6 units of blood.</p> Signup and view all the answers

<p>Perform uterine massage and administer utero-tonic drugs.</p> Signup and view all the answers

<p>One hand forms a fist and is inserted into the vagina while the other hand compresses the abdomen to support the uterus.</p> Signup and view all the answers

<p>A firm and rounded uterus at the level of the umbilicus and an elongated umbilical cord.</p> Signup and view all the answers

<p>Avoid giving oxytocic drugs until after removal of the placenta.</p> Signup and view all the answers

<p>Obstructed labor is a common cause of uterine rupture.</p> Signup and view all the answers

<p>Forceps use on an undilated cervix and rapid delivery of the after-coming head in breech presentation.</p> Signup and view all the answers

<p>They help contract the uterus and prevent postpartum hemorrhage.</p> Signup and view all the answers

<p>Uterine massage and intravenous administration of oxytocic drugs.</p> Signup and view all the answers

<p>PPH is defined as excessive bleeding occurring within the first 24 hours after delivery.</p> Signup and view all the answers

<p>Secondary PPH occurs after 24 hours and up to 6 weeks post-delivery.</p> Signup and view all the answers

<p>About 25% of the annual 500,000 pregnancy-related deaths are attributed to PPH.</p> Signup and view all the answers

<p>Common causes include retained products of conception and prolonged obstructed labor.</p> Signup and view all the answers

<p>A healthy woman's blood volume increases by 30-50% during normal singleton pregnancy.</p> Signup and view all the answers

<p>General anesthesia used during operative delivery can cause relaxation of the myometrium.</p> Signup and view all the answers

<p>Thrombin refers to bleeding disorders that can contribute to PPH.</p> Signup and view all the answers

<p>Over distention can occur due to conditions like polyhydramnios or multiple pregnancies.</p> Signup and view all the answers

<p>Uterine massage is an effective method for managing uterine atony.</p> Signup and view all the answers

<p>Manually remove any retained pieces of the placenta and administer oxytocic drugs.</p> Signup and view all the answers

<p>A couvelaire uterus signifies severe placental abruption, where blood infiltrates the uterine wall, possibly leading to significant complications.</p> Signup and view all the answers

<p>Obstructed labor and improper use of oxytocic drugs are two causes of uterine rupture.</p> Signup and view all the answers

<p>Bimanual compression is used to compress the uterus to promote firmness and prevent hemorrhage.</p> Signup and view all the answers

<p>Active management of the third stage of labor, which includes administering utero-tonic agents like oxytocin.</p> Signup and view all the answers

<p>Placenta accreta, placenta increta, and placenta percreta.</p> Signup and view all the answers

<p>Oxytocic drugs should be avoided until after manual removal of the placenta.</p> Signup and view all the answers

<p>Placental abruption and amniotic fluid embolism.</p> Signup and view all the answers

<p>A firm, rounded mass at the level of the umbilicus and an elongated umbilical cord indicate placental separation.</p> Signup and view all the answers

<p>Uterine artery embolization is a common intervention for unresolved uterine atony.</p> Signup and view all the answers

<p>Ensure that at least two peripheral intravenous lines are established.</p> Signup and view all the answers

<p>If bleeding continues despite a contracted uterus, a traumatic lesion may be suspected.</p> Signup and view all the answers

<p>It aids in the expulsion of the placenta while ensuring uterine contraction.</p> Signup and view all the answers

<p>IV administration of oxytocin or ergometrin during the delivery of the anterior shoulder.</p> Signup and view all the answers

<p>It allows for accurate monitoring of urine output and assists in bladder management.</p> Signup and view all the answers