PPH stages and their significance?
How many stages of postpartum hemmorhage are there?
4
Stage zero
stage 1 (mild)
stage 2 (moderate)
stage 3 (severe)
What is placenta previa?
A complication where the placenta attaches low in the uterus, either partially or fully covering the cervix.
Continuous monitoring of these two vital signs are essential to detect ongoing blood loss or hemodynamic instability.
Blood pressure and heart rate
How much blood loss is typical in a stage zero?
less that 500 mL for a vaginal birth
less than 1000mL for a C section
For the baby, what major complication could happen if a vaginal delivery occurs?
Fetal hypoxia
Which lab value is critial to assess following a PPH?
Hemoglobin
How much blood loss is to be expected in a stage one, and what signs and symptoms are to be expected?
More than 500mL for a vaginal birth, more than 1000mL C section. Often asymptotic, dizzy, normal urine output.
What emergency could happen if a vaginal delivery were to happen?
Placental abruption
Doing what assessment can help identify persistent bleeding after a PPH?
A fundal assessment
How much blood loss is to be expected in a stage two, and what signs and symptoms are to be expected?
1000 - 1500mL,
tachycardia, Diaphoretic/ weak, slight change in BP
Do you think lifestyle choices increase your chances of developing placenta previa? If so, what kind?
Yes, substance use (cocaine in particular), smoking and being overweight all increase the risk of developing placenta previa.
What percent of women suffer from a PPH?
5%
How much blood loss is to be expected in a stage three, and what signs and symptoms are to be expected?
More than 1500 - 2000 mLs.
Delayed cap refill, cool extremities, tachypnea, restlessness, pallor, confusion, anuria
What is a symptom the client experiences indicating placenta previa in the 2nd or 3rd trimester?
Painless, bright red vaginal bleeding
Up to how many weeks postpartum can a PPH occur?
12 weeks