Week 5 PP Complications

Question 1

This is defined by 500 ml loss in vaginal delivery or 1000 ml loss in c section and also a drop of hematocrit >10%

Answer 1

PP Hemorrhage

Causes include
Uterine Atony or failure of uterine muscle to contract after delivery

Question 2

What is the care for a post partum bleed?

Answer 2

Massage fundus
Increase IVs and administer oxytocic’s
- Oxytocin, Pitocin
- Cytotec
- TXA
- Hemabate
- Methergine

Empty Bladder- May straight cath

Monitor VS

Notify MD

Question 4

10- 40 units in 500 ml to 1 liter

Answer 4

Oxytocin and Pitocin

Question 4

Should not be used in woman with asthma
Causes diarrhea and give lomotil
Failure to reverse hemorrhagic bleeding with the above

Answer 4

Hemabate 250 mcg IM repeat in 5 minutes

Question 4

Do not use in hypertensive Patients 0.2 mg I only

Answer 4

Methergine

Question 4

May cause diarrhea
800mcg- 1200 mcg

Answer 4

Cytotec

Question 4

TXA 1 gram bolus in 100 ml of normal NS over 1-15 min IVPB or IVP

Answer 4

True

Question 4

PP hemorrhage can lead to

Answer 4

DIC

Question 4

Medications in an obstetric emergency and surgical intervention is advised

Answer 4

True

Question 4

In DIC patients have too little and too much what?

Answer 4

Clotting factors

Secondary to underlining hemorrhage

Question 4

Hematological disorder
Form of clotting that is diffuse and consumes large amount of clotting factors

Answer 4

DIC

Causes widespread external and internal bleeding or both

Question 4

Oozing and bleeding from sites

May be treated with transfusion of blood, FFP, platelets, and anticoag. therapy

Answer 4

DIC

Question 4

Most common causes of DIC in pregnancy is

Answer 4

Excessive blood loss
Inadequate blood component replacement
Placental abruption
AFE
Severe Preeclampsia
HELLP Syndrome

Question 5

Too much clotting leads to

Answer 5

Organ ischemia

Question 5

Consumptive coagulopathy that results in depletion of platelets and clotting factors, early diagnosis and prompt and appropriate management ae critical in reducing maternal and perinatal death and complication rate

Answer 5

DIC

Question 6

Too little clotting leads to

Answer 6

Bleeding

Question 7

HELLP stands for

Answer 7

Hemolysis
Elevated liver enzymes
Low platelets

Question 8

Symptoms of HELLP

Answer 8

N/V, RUQ pain, high BP, headache

Question 9

Rare but high mortality rate
Acute and rapid collapse mother and or fetus caused by allergic reaction to amniotic fluid entering maternal circulatory system
- Initially causes rapid rsp. collapse, then hemorrhage, leading to DIC

Answer 9

AFE or ASP

Question 10

Treatment is supportive and include massive transfusion therapy

Surgical removal of uterus may be required to control hemorrhage

Answer 10

AFE or ASP

Question 11

What is unpredictable and unpreventable and fatal

Historically diagnosis has been post mortem but early Tx and and supportive Tx more likely

Answer 11

AFE ASP