Post Partum Haemorrhage Flashcards
(12 cards)
What are the Four T’s of Post partum Haemorrhage?
Tone (uterine atony
Trauma (To genital Structures)
Tissue (Retention of placenta or membranes)
Thrombin (Coagulopathy)
What is the most common cause of post partum haemorrhage?
Tone
What patients are at a igher risk of PPH (5 things)
- Multiple pregnancies
- More than 4 pregnancies
- Previous PPH
- Previous APH
- Large baby
Who should be contacted during PPH if there are any concerns?
PIPER through the clinician
Where severe bleeding occurs at 24hrs to 6 weeks post birth what is the known as
secondary PPH
What is the Mx for Secondary PPH?
- Consult with receiving hospital regarding Oxytocin administration
What is considered PPH
- Blood loss > 500mL in first 24hours from birth
What is the Mx if the Fundus is firm
- High flow O2
- Pain releif
- Fluid
- Mx any visible lacerations with dressing and firm pressure
How much fluid should be administered in PPH
- BP < 90
- 40mL/Kg
- Consult for further
- 20mL/kg if no consult available
What is the initial Mx if the Fundus is not firm?
- Mx as per fundus firm
- Fundus does not normally become firm prior to placental delivery
- Massage Fundus until firm and blood loss reduces
- Encourage mother to empty bladder if possible
- Encourage baby to suckle breast
If fundus remains not firm after initial Mx what is the next step
- Oxytocin 10 IU IM
- repeat 5/60 if bleeding continues
- TXA over 10minutes (Do not delay transport)
What is the Mx if there is Intractable haemorrhage in PPH
- Perform external abdominal aortic compression
- Locate point of compression just above umbilicus and slightly to the left
- Apply downward pressure with a closed fist directly through the abdominal wall
- Effectiveness of compression evaluated by assessing palpable femoral pulse
