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Flashcards in Post-Partum Complications Deck (56)
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1

PPH is defined as a blood loss greater than what after delivery?

500ml

2

What is meant by a primary PPH?

PPH in the first 24 hours after delivery

3

What is meant by secondary PPH?

PPH between 24 hours after delivery and 12 weeks post-natally

4

What amount of blood loss would be classified as a minor PPH?

500-1000ml

5

What amount of blood loss would be classified as a moderate PPH?

> 1000 - 2000ml

6

What amount of blood loss would be classified as a severe PPH?

> 2000ml

7

Primary PPH is most likely caused by one of the four T's- what are these?

Tone, trauma, tissue, thrombin

8

What is the most common cause of a primary PPH?

Uterine atony

9

What are the two main causes of secondary PPH?

Retained products or infection (endometritis)

10

The risk of PPH is reduced by 60% with the use of what intervention?

Active management of the third stage of labour

11

Loss of more than 1000mls of blood from PPH causes what presentation?

Maternal collapse

12

Minor PPH can cause what clinical signs?

Tachycardia, tachypnoea and hypotension

13

Severe PPH can result in hypoperfusion of end organs- what is most common?

AKI

14

The aim of management of PPH is to treat the underlying cause while administering adequate resuscitation with what?

Fluids and blood products

15

For women with severe PPH, what other blood product is transfused alongside red blood cells? At what ratio is this transfused?

FFP, at a 1: 1 ratio with RBCs

16

What is the non-medical treatment for uterine atony causing PPH?

Rubbing up the abdomen and bimanual uterine compression

17

When uterine atony is suspected as the underlying cause of PPH, drugs that make the uterus contract are given. Give some examples of these?

Syntocinon, Syntometrine, misoprostol

18

How is PPH caused by trauma treated?

Repair perineal trauma

19

How is PPH caused by retained products treated?

Remove retained products in theatre

20

What measures can be used to temporarily control bleeding from a PPH before the woman is taken to theatre?

Haemostatic ballon, uterine compression suture

21

If bleeding from a PPH persists despite all interventions, what is the management?

Hysterectomy

22

If a woman is diagnosed with a post-natal infection, what management is required for the baby?

Septic screen and potentially prophylactic antibiotics

23

Puerperal sepsis is described as a systemic infection within how long after birth?

6 weeks

24

What is the commonest organism causing puerperal sepsis caused by perineal infection or endometritis?

Group A strep

25

What is the commonest organism causing puerperal sepsis caused by mastitis or wound infections?

Staph aureus

26

Prophylactic antibiotics are given before a C-section to reduce the risk of which infections?

Endometritis and wound infections

27

Offensive smelling bloody discharge and abdominal pain after delivery suggests that what complication has developed?

Endometritis

28

In women with puerperal sepsis, broad spectrum IV antibiotics are given within one hour of presentation to hospital. What combination of antibiotics is most commonly used?

Co-amoxiclav and metronidazole

29

Why does pregnancy cause reduced blood flow, contributing to the increased risk of VTE?

Compression of the iliac veins by the gravid uterus

30

What medication is given to women who are deemed high-risk of developing VTE both during and after pregnancy?

LMWH