Postpartum Hemorrhage - PDF Study Guide

GROUP 14 Postpartum haemorrhage (PPH) is defined as excessive bleeding following childbirth, occurring withing 24 hours or up to 12 weeks later. It is classified by blood loss exceeding 500ml after a vaginal delivery or 1000ml after a caesarean section  TYPES OF POSTPARTUM HEAMORRHAGE...

GROUP 14 Postpartum haemorrhage (PPH) is defined as excessive bleeding following childbirth, occurring withing 24 hours or up to 12 weeks later. It is classified by blood loss exceeding 500ml after a vaginal delivery or 1000ml after a caesarean section  TYPES OF POSTPARTUM HEAMORRHAGE : Loss of more than or equal to 500ml blood from the genital tract within 24 hours of delivery Loss of more than or equal to 500ml blood from the genital tract between 24 hours of delivery and 12 weeks post delivery  SYMPTOMS OF POSTPARTUM HAEMORRHAGE  Excessivebleeding (saoking through one or more pads an hour )  Weakness or dizziness  Rapid heart rate  Low blood pressure  Pale skin AETIOLOGY  CAUSES  1.UTERINE ATONY  RETAINED PLACENTA  GENITAL TRACT LACERATION  COAGULOPATHY  ACUTE INVERSION OF UTERUS  UTERINE ATONY  Uterus fails to contract following delivery of placenta.  Predisposing conditions that can cause uterine atony  Multiparity (Fibrosis of uterine muscle)  Over distention of uterus eg. Macrosomia, polyhydramnios  Prolong labour (uterine inertia)  Fibroid  Placenta previa  Oxytocin induce labour  RETAINED PLACENTA  Prevent a uterus from contracting efficiently  Placenta separated but undelivered  Placenta partly or wholly attached  Placenta acreta GENITAL TRACT LACERATION Perineal or virginal tears 1. instrumental delivery Episiotomy can extend upwards Uterine rupture  COAGULOPATHY  Clotting disorder  von Willebrand’s disease, platelet disorder  Unidentified dead foetus  Amniotic fluid embolus –amniotic fluid entering maternal circulation  ACUTE INVERSION OF UTERUS Uterus is pulled inside out and the fundus at the introitus. Caused by traction on the umbilical cord before placenta has separated  RISK FACTORS  Previous history of PPH  Prolong labour  Use of certain medications during delivery e.g magnesium sulphate  Multiple pregnancies  Uterine overdistension  COMPLICATION  Circulatory collapse – shock  Organ failure, stroke, death  Sheehan’s syndrome  Damage to pituitary  Pituitary necrosis  Puerperal anaemia  Fear of further pregnancies  MANAGEMENT Uterine massage to stimulate contraction Medication to promote uterine contractions eg. Oxytocin Iv fluids and blood transfusion if necessary Hysterectomy in severe cases  PREVENTION Monitoring during labour and delivery for signs of PPH Administration of uterotonics immediately after delivery Ensuring complete delivery of placenta  CONCLUSION  Postpartum haemorrhage is a medication emergency that requires prompt recognition and treatment to prevent complications including shock and even death.  Its important for healthcare providers to be well prepared to manage this conditions  Reference  World health organization (WHO)  Postpartum haemorrhage(https://www.who.int/news- room/fact-sheets/detailed/postpartum-haemorrhage)  Mayo clinic- Postpartum Haemorrhage( https://www.mayoclinic.org/diseases- conditions/postpartum-hemorrrhage/symptoms- causes/syc-20346193)  GROUP MEMBERS 1. Gertrude Ampomah – Pu/210140 2. Okai-Twum Priscilla Marfoah – Pu/210894 3. Prince Offei Agyei – Pu/210260 4. Fianu Foster – Pu/210770 5. Yamoah Grace Keziah – Pu/211184 6. Dzigbede Exornam Irene – Pu/210937 7. Nana Ama Nkrumah Kwaw – Pu/210248 8. Janet Odzu – Pu/210179 9. Emmanuella Frimpong – Pu/211204 10. Benita Adu Agyemang Brown – Pu/211023