PPH CPG Notes Flashcards
(12 cards)
When should fundal massage be performed?
Only when the fundus is not firm. Massaging a firm fundus may worsen bleeding.
Fundal massage is a technique used to promote uterine contraction and minimize bleeding after childbirth.
What are the four ‘T’s that summarise causes of PPH?
• Tone (uterine atony)
• Trauma (to genital structures)
• Tissue (retained placenta/membranes)
• Thrombin (coagulopathy)
PPH stands for postpartum hemorrhage, which can be caused by various factors.
What is the most common cause of PPH?
Uterine atony (loss of tone).
Uterine atony is the failure of the uterus to contract effectively after delivery.
Why is an empty and contracted uterus not a concern for bleeding?
Because an empty and contracted uterus does not bleed.
A well-contracted uterus helps to control bleeding by compressing the blood vessels.
List 5 risk factors for developing PPH.
• Multiple pregnancy
• >4 pregnancies
• Past PPH
• History of APH
• Large baby.
APH stands for antepartum hemorrhage, which can also contribute to risks during delivery.
Why should fundal massage be avoided before the placenta is delivered?
It may cause premature separation and worsen bleeding.
Premature separation of the placenta can lead to significant complications.
What should be continuously checked if the placenta is not yet delivered?
PV (per vaginal) bleeding and vital signs.
Monitoring these parameters is crucial to ensure patient safety and timely intervention.
What is secondary PPH?
Severe bleeding that occurs 24 hrs to 6 weeks post-birth.
Secondary PPH can be caused by retained products of conception or infection.
What should you do if secondary PPH is suspected?
Consult the receiving hospital regarding Oxytocin administration.
Oxytocin can help stimulate uterine contractions to reduce bleeding.
When is tranexamic acid indicated?
If haemorrhage continues despite fundal massage, oxytocin, and direct pressure on visible lacerations.
Tranexamic acid is an antifibrinolytic that helps reduce bleeding.
Should tranexamic acid delay transport?
No, administration must not delay transport.
Timely transport is crucial for the patient’s safety in emergencies.
What emergency service should you contact for neonatal retrieval support?
PIPER – Paediatric Infant Perinatal Emergency Retrieval via Clinician or 1300 137 650.
PIPER provides specialized neonatal retrieval services.
