Flashcards in 16 - Obs - The Puerperium - PPH Deck (11):
1’ PPH = loss of >? blood 1000ml after ? ?). ?% women. Major cause of maternal ?
3 common causes
3 rare causes
common - retained placental fragments, atonic uterus, perineal trauma
rarer - uterine rupture, cervical tear, high vaginal tear
Uterine: ?%. Uterus fails to ?
properly, as it’s ? or ?
placenta/part of placenta. Atony more common w ?
labour, grand ? and ? of uterus (? and ? preg) and fibroids.
Retained Placenta: 2.5% delivs. ? separation -> blood accum in ?, which rises. ? may occur in absence of ? loss.
Coagulopathy: Rare. ?
disorders, ? therapy or ??? all cause PPH.
Vaginal: ?%. Bleeding from ?
tear or ? obvious, ? ? tear considered, esp if ? deliv.
Cervical Tears: Rare, but ass w precipitate labour and ?
Routine use of ? in ? stage reduces incidence by ?%. As effective as ergometrine, which often causes ?, and is contraindicated in ? women.
Blood loss should be ? after deliv of ?. Enlarged uterus above ? suggests ? cause. Vaginal ? and ? inspected for tears. Blood loss can be ?– collapse w/o pain if ?bleeding
Resuscitate: Pt lied ?, ??
access, ? match and blood ?
restored. ?, haematological and senior ? help.
Retained placenta: Removed ? if bleeding or not expelled as normal within ?mins.
To ID and Treat cause:
?? to exclude rare uterine ?
and uterus bimanually ?. Vaginal ? are palpable. ?cause common and ? given IV to contract uterus if no ?. If failure, examine inder ??(EUA).