OB PPH Flashcards Preview

OB > OB PPH > Flashcards

Flashcards in OB PPH Deck (16)
Loading flashcards...
1

Contraindication to Methergine

HTN

2

Repeat interval of Methergine

Total repeat doses

2 hours
(In practice most will repeat after 15 minutes)

No max amount

3

Hemabate

1. Dosage
2. Repeat interval
3. Total repeat doses
4. Contraindication
5. Class of drug

1. 250 micrograms
2. 15 mins
3. 8 doses
4. Asthma
5. PGf alpha

4

Dose of cytotec for PPH

1 mg

5

PRBC

1. Volume
2. Effect on hgb
3. Effect on hct

1. 250 cc
2. Hgb inc by 1
3.Hct incr 3%

6

Plt

1. Volume
2. Content
3. Effect

1. 50cc
2. 50 mil plt
3. Rises 5-10,000

7

FFP

1. Volume
2. Content
3. Effect

1. 250cc
2. 200mg Fib, fac V, VIII, antithrombin III
3. Until fibrinogen >100, or normal PT

8

Cryoprecipitate

1. Volume
2. Content
3. Effect
4. Dose

1. 25 cc
2. 200 mg Fib, fac VIII, XIII, von Willebrand
factor
3. Until Fib >100, normal PT
4. 1u/5-10 kg wt

9

Rate of crystalloid repletion per EBL

3cc crystalloid/1cc EBL

10

Definition of Massive Transfusion Protocol

replacement of >50% of blood volume in 12-24 hours

11

O'Leary Stitch

Uterine artery ligation

12

B-lynch stitch placement

3cm below incision

13

Warfarin
1. Mechanism of Action
2. Placental Transfer
3. Teratogenic
4. Labs for monitoring
5. Clinical Aim
6. Dose
7. Antidote
8. Side Effects
9. Half-life

1. Factors 2, 7, 9, 10
2. Yes
3. Yes
4. PT, INR
5. 2-3.0
6. Variable
7. Vit K
8. Fetal bleeding, Fetal Coumadin Synd (1TM- stippled epiphyses, limb+nasal hypoplasia, 2TM- optic atrophy + microcephaly)
9. 4 hours

14

Heparin
1. Mechanism of Action
2. Placental Transfer
3. Teratogenic
4. Labs for monitoring
5. Clinical Aim
6. Dose
7. Antidote
8. Side Effects
9. Half-life

1. Co-factor for Antithrombin Xa
Increases inhibition of thrombin & Factor Xa
2. No
3. No
4. PTT
5. 1.5-2.0
6. 1000 u/hr or 6000 u Q6 hr (proph 5000 u BID)
7. Protamine sulfate (1mg/100u Heparin) Max 15mg/15 min
8. Maternal thrombocytopenia , osteoporosis (both w/ long term use)
9. 1.5 hrs

15

LMWH (Enoxaparin)
1. MOA
2. Monitoring
3. Advantages
4. Disadvantages
5. Placental Transfer

1. Inhibits factor Xa (better than reg heparin)
2. only w/ therapeutic anticoag- anti-Xa Q4-6 wks
(obtain 4 hrs after dosing)
3. Longer half life (once or twice daily dosing), dec risk of thrombocytopenia, osteoporosis, post-op bleeding
4. cost, inc risk of epidural hematoma (wait >12 hrs w/ prophylactic dosing for epidural and > 24 hrs w/ therapeutic dosing), contraind in preg w/ prosthetic valves

16

Changes in clotting system in normal pregnancy

1. incr fac 5, 7, 9, 10, 12 & fibrinogen
2. inc plasminogen activator inhibitor type I & II (inhibits plasminogen activator