post partum haemorrhage

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why is the most common cause if obstetric haemorrhage immediately after delivery?

uterine atony- uterus fails to contract after delivery
what is primary post partum haemorrhage?

loss of over 500 mls within 24 hours of delivery
what is massive post partum haemorrhage?

loss of 50% of mothers blood volume within 3 hours of delivery
what is secondary post partum haemorrhage?

abnormal or excessive bleeding from the birth canal between 24 hrs and 12 weeks post postnatally
what are the risk factors for a post partum haemorrhage?
- previous ante or post PH
- long labour (>12hrs)
- anything that increases the size of the uterus
- advanced maternal age (>40)
- obesity
- multiparity- greater than 5 deliveries
- uterine fibroids
- partial seperation of the placenta/ placenta accreta
what are the 4 primary causes?
- Tone
- Trauma
- Tissue
- Thrombin
what does it mean by tone?

uterine atony
what does it mean by trauma?

vaginal tear
what does it mean by tissue?

retained placenta
what does it mean by thrombin?

clotting problems
what are the secondary causes?
- retained placenta or membranes
- sepsis
what are the two treatment regimes for if the cause of the PPH was tone?
- placenta has been delivered
- placenta has not been delivered
what do you do if the placenta has been delivered?
- Uterine massage
- entonox to help with pain
how do you do uterine massage?
- palpate for top of uterus- usually height of umbilical
- cupped hand- pressure towards back of pt and down towards uterus
- use circular motion
what do you do if the placenta has not been delivered?
- do not perform uterine massage
- may cause further haem
What should you consider for secondary PPH?
- Cause e.g. tissue/ thrombin
- likely sepsis, retained placenta

Author

davidgoddard93

346954

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post partum haemorrhage

Description

post partum haemorrhage

Updated

2019-05-14T06:53:47Z

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