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  • Post Partum Haemorrhage

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    jayashreeselvaraj
    71 просмотров20 страниц
    Postpartum haemorrhage occurs in 4-6% of deliveries and can be primary (within 24 hours) or secondary (beyond 24 hours). The main causes are atonic uterus (80%) and trauma (20%), such as retained placenta or tissues. Risk factors include grand multiparity, overdistention of the uterus, and issues with the third stage of labour such as improper management. Diagnosis involves vaginal examination and vital sign/blood monitoring. Management focuses on emptying the uterus, replacing blood loss, and ensuring hemostasis through steps like uterine massage, medications, and potentially more invasive procedures if needed. Treatment of secondary causes focuses on infection control and further intervention if needed.

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    Postpartum haemorrhage occurs in 4-6% of deliveries and can be primary (within 24 hours) or secondary (beyond 24 hours). The main causes are atonic uterus (80%) and trauma (20%), such as retained placenta or tissues. Risk factors include grand multiparity, overdistention of the uterus, and issues with the third stage of labour such as improper management. Diagnosis involves vaginal examination and vital sign/blood monitoring. Management focuses on emptying the uterus, replacing blood loss, and ensuring hemostasis through steps like uterine massage, medications, and potentially more invasive procedures if needed. Treatment of secondary causes focuses on infection control and further intervention if needed.

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    © All Rights Reserved
    Скачайте в формате PPTX, PDF, TXT или читайте онлайн в Scribd
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    71 просмотров20 страниц

    Post Partum Haemorrhage

    Загружено:

    jayashreeselvaraj
    Postpartum haemorrhage occurs in 4-6% of deliveries and can be primary (within 24 hours) or secondary (beyond 24 hours). The main causes are atonic uterus (80%) and trauma (20%), such as retained placenta or tissues. Risk factors include grand multiparity, overdistention of the uterus, and issues with the third stage of labour such as improper management. Diagnosis involves vaginal examination and vital sign/blood monitoring. Management focuses on emptying the uterus, replacing blood loss, and ensuring hemostasis through steps like uterine massage, medications, and potentially more invasive procedures if needed. Treatment of secondary causes focuses on infection control and further intervention if needed.

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PPTX, PDF, TXT или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 20

    4-6%

    TYPES
    PRIMARY within 24 hrs after delivery
    Third stage haemorrhage
    True post partum haemorrhage
    SECONDARY- beyond 24 hrs after delivery

    casues
    atonic

    traumatic

    retained tissues

    bloocoagulopathy

    20%

    80%

    Grand multipara
    Over distention of uterus
    Malnutrition and anaemia
    Antipartum haemorrhage
    Prolonged labour
    Anesthesia

    Mismanaged third stage of labour


    Placenta

    Intiation and augmentation of


    delivery by oxytocin
    Malformation of uterus
    Uterine fibroid

    Retained tissues
    bits of placenta
    blood clots
    Drugs
    use of tocolytic drugs
    Combination of atonic and traumatic
    causes
    Blood coagulation disorder

    Vaginal

    examination
    Visible vaginal bleeding
    Vital signs
    Blood investigation

    Antenatal

    Improvement of helth status

    Identification of high risk cases

    Blood grouping

    Placetal localisation

    Immediate post partum assessment

    Intranatal

    Active management of 3 ed stage of labour

    Oxytocin infution

    Exploration of utero vaginal canal

    Examination of placenta

    Team management

    Intelligent manage ment

    Skillled super vision

    Prompt detection
    Effective institutional therapy

    To empty uterus contents


    To replace the blood
    To ensure the effective haemostasis
    Step of management
    Placental site bleeding1) To palate the funds
    2) To start crystalloid solution
    3) Oxytocin 10 units or methergin 0.2mg iv
    4) Catheterisation of bladder
    5) Antibiotics
    6) Manual removal of placenta

    Placenta separated

    Express the placenta out

    not separated

    MRP

    MANAGEMENT OF TRAMATIC
    HAEMORRHAGE

    Principles : simutaneous approach


    Communication
    Resuscitation
    Monitoring
    Arrest of bleeding

    Management
    Team help
    Large pore cannula
    Maintain warm and flat posistion
    Arrange for blood transfusion
    Replace 2litre of crystalloids and colloids or
    plasma volume expanders
    Oxygen support
    Oxytocin infusion 20unitsin 1litre of NS
    60drops /mts
    Continues vital monitoring

    Uterine Massage

    Bimanuval Uterine Compression

    Tight Intrauterine Packing With Utreine

    Tamponade

    Ballon Tamponade

    Utreine revascularisation procedure


    Ligation of uterine artery and uter- ovarian
    anastomotic vessels

    Ligation of anterior division of internal iliac

    artery

    B-Lynch compression and multiple square


    sutures

    Angiographic arterial embolisation with

    gelatin sponge

    Hystercetomy

    Causes

    Retained Placental Bits

    Infection And Seperation Of Slough Over

    a deep Cervico Vaginal Laceration

    Endometritis And Subinvultion Of Uterus

    Lscs After 10-14 Days

    PrinciplesWithdrawal Bleeding Following

    Oestrogen Therapy For Supression Of


    Lactation

    Ca Cervix

    Placental Polyp And Fibroid Polyp

    Assess the amount of blood loss and replace


    Find out cause and to take appropriate steps to
    rectify

    Supportive therapy

    Conservative therapy

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