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cce_obstetrics_post-partum hemorrhage (complications (shock, puerperial…
cce_obstetrics_post-partum hemorrhage
history
causes
secondary PPH
retained placental tissue
primary PPH
thrombin
coagulopathy
tissue
retained products of conception
trauma
genital tract injury
tone
uterine atony
complications
shock
puerperial anemia
Sheehan's syndrome
investigations
blood
cbc, clotting, LFTRFT (cross-match)
physical examination
further assessment
uterine contraction
genital tract injury
is it a complete placenta
emergency
Doptone
vitals
airway breathing
circulation
(assess amount of blood loss) > 1L: transfusion
trauma
repair
thrombin
(treat underlying cause) transfusion of blood, blood products
tissue
GA: manual removal of placenta
tone
IM carboprost
PR misoprostol
IV synctocinon
intrauterine balloon tamponade
B-lynch suture
bimanual compression
internal iliac ligation
hysterectomy
uterine artery embolization
secondary PPH
24 hours - 6 weeks after delivery
any bleeding
primary PPH
Caesarean section
more than 800 mL
third stage
more than 500 mL