Obstetric Emergencies Flashcards
Definition of Massive Obstetric Hemorrhage?
Defined as >1500mL of blood loss (30-40% of the patient’s blood volume)
Causes of Massive Obstetric Hemorrhage?
- Antepartum
- Intrapartum
- Postpartum
Antepartum
- Placental Abruption
- Placenta Previa
- Severe Chorioamionitis
- Severe pre-eclamsia w/ hepatic rupture
Intrapartum causes
- intrapartum abruption
- uterine rupture
- amniotic fluid embolism
- complications of CAESAREAN
- placenta accreta or percreta
Postpartum causes
- atonic uterus
- genital tract trauma
- coagulopathy
- retained products of conception
Blood flow to the uterus at term is about _________mL/minute and to the placenta __________mL/minute
Blood flow to the uterus at term is about 500-800mL/minute and to the placenta 400mL/minute
Management of Massive Obstetric Hemmorage?
Mechanism of Shoulder Dystocia?
Risk Factors of Shoulder Dystocia?
Antenatal risk factors – history of shoulder dystocia, post-term pregnancy, fetal macrosomia, diabetes mellitus, BMI >30 or excessive weight gain in pregnancy
Intrapartum risk factors – prolonged labour, instrumental vaginal delivery (especially rotational deliveries)
Management of Shoulder Dystocia?
HELPERR
- call for help
- episiotomy
- legs (Mc Robert’s manoeuvre: flex, abduct and externally rotate the hips as much as possible to open the pelvis)
- pressure (suprapubic pressure)
- enter (rotational manoeuvres)
- remove (the posterior arm)
- roll (the patient onto all fours)
Manoeuvres for Shoulder Dystocia
Diagnosis of Pre-Eclampsia?
Diagnosis of pre-eclampsia requires hypertension (>140/90mmHg) on more than one occasion and proteinuria (>300mg/24h or PCR of 30mg/mmol or urine dipstick protein of 2+ or more), in the absence of UTI
Features of Severe Pre-Eclampsia?
General Management of Pre-Eclampsia?
Risk Factors for Cord Prolapse?
Management of Cord Prolapse?
