Flashcards in Post-Partum Complications Deck (56)
PPH is defined as a blood loss greater than what after delivery?
What is meant by a primary PPH?
PPH in the first 24 hours after delivery
What is meant by secondary PPH?
PPH between 24 hours after delivery and 12 weeks post-natally
What amount of blood loss would be classified as a minor PPH?
What amount of blood loss would be classified as a moderate PPH?
> 1000 - 2000ml
What amount of blood loss would be classified as a severe PPH?
Primary PPH is most likely caused by one of the four T's- what are these?
Tone, trauma, tissue, thrombin
What is the most common cause of a primary PPH?
What are the two main causes of secondary PPH?
Retained products or infection (endometritis)
The risk of PPH is reduced by 60% with the use of what intervention?
Active management of the third stage of labour
Loss of more than 1000mls of blood from PPH causes what presentation?
Minor PPH can cause what clinical signs?
Tachycardia, tachypnoea and hypotension
Severe PPH can result in hypoperfusion of end organs- what is most common?
The aim of management of PPH is to treat the underlying cause while administering adequate resuscitation with what?
Fluids and blood products
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
What is the non-medical treatment for uterine atony causing PPH?
Rubbing up the abdomen and bimanual uterine compression
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
How is PPH caused by trauma treated?
Repair perineal trauma
How is PPH caused by retained products treated?
Remove retained products in theatre
What measures can be used to temporarily control bleeding from a PPH before the woman is taken to theatre?
Haemostatic ballon, uterine compression suture
If bleeding from a PPH persists despite all interventions, what is the management?
If a woman is diagnosed with a post-natal infection, what management is required for the baby?
Septic screen and potentially prophylactic antibiotics
Puerperal sepsis is described as a systemic infection within how long after birth?
What is the commonest organism causing puerperal sepsis caused by perineal infection or endometritis?
Group A strep
What is the commonest organism causing puerperal sepsis caused by mastitis or wound infections?
Prophylactic antibiotics are given before a C-section to reduce the risk of which infections?
Endometritis and wound infections
Offensive smelling bloody discharge and abdominal pain after delivery suggests that what complication has developed?
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
Why does pregnancy cause reduced blood flow, contributing to the increased risk of VTE?
Compression of the iliac veins by the gravid uterus