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Physiology
Non-medication mgmnt
Definitions
Medications
Causes of PPH
100
At what blood loss percentage will signs of hemorrhage begin to be apparent?
What is >15%?
100

Uterine massage, empty the bladder, bimanual uterine compression, IV Fluids, Intrauterine Tamponade, and Uterine Packing.

What are examples of non-surgical interventions for PPH?

100

Caused by uterine atony, retained placenta (especially accreta), coagulation defects, and uterine inversion

What is primary hemorrhage (within 24 hours)?

100

600 to 800 mcg given rectal or sublingual; 1000 mcg max dose.

What is misoprostol?

100
80% of PPH caused by this.
What is uterine atony?
200
Increase of 25%
What is red cell mass?
200
  • Induced or accelerated labor with oxytocin
  • Active Management of The 3rd Stage of Labor
  • Spontaneous delivery of the placenta
  • Exploration of the utero-vaginal canal
  • Examine the placenta

What are ways to prevent or reduce the incidence of PPH?

200

Cumulative blood loss ≥ 1000 mL OR blood loss accompanied by signs or symptoms of hypovolemia within 24 hours after birth, regardless of route of delivery.

What is Postpartum Hemorrhage?

200

1 gm IV; if bleeding persists after 30 minutes, may infuse a second 1 gm dose.

What is TXA (transexamic acid)?

200
May be treated with MEU, curettage
What is retained placental tissue?
300
Increase of 40%
What is plasma volume?
300
Placement of Gelfoam, coils, glue, or balloons in offending vessels
What is arterial embolization? Should be performed in patient with stable vital signs but persistent bleeding.
300

Obesity, Gestational Diabetes, Preeclampsia, Polyhydramnios, and Antepartum Hemorrhage

What are examples of moderate-risk factors for PPH?

300

Stimulates sustained contraction of the uterus and causes arterial vasoconstriction.

What is 0.2 mg IM for methergine? May be given  every 2-4 hours. 

300
Cause that may be "hidden" but can lead to significant EBL with c/o pressure / pain. Single source not usually able to be identified.
What is genital tract hematoma? May be treated with I&D, drain placement, incisional suture, vaginal packing, or management by interventional radiology.
400
1 unit of packed RBC will usually increase Hgb by how much?
What is 1 g/dL?
400

Technique that provides even pressure to compress uterine corpus and decrease bleeding.

What is B-Lynch technique?

400

Previous PPH, Anemia, IVF, multiples, Placental abnormalities, Macrosomia, C/S, Sepsis, and No Antenatal Care


What are examples of high-risk factors for PPH?

400

250 mcg IM every 15 min, max 8 doses

What is hemabate?

400
Ruled out by careful assessment of lower genital tract.
What are lacerations?
500
What are the two types of blood components that will increase fibrinogen by 10 mg/dL, and how do they differ?
What is cryo and FFP? Both with fibrinogen and Factor VIII. FFP (250 cc) also with antithrombin III and factor V. Cryo (40 cc) also with factor XIII and von Willebrand factor.
500
Describe square suturing.
What is placement of multiple sutures securing anterior to posterior uterine walls?
500

The most common cause of PPH that accounts for 80% of hemorrhages.

What is uterine atony?

500

Routine medication given after delivery; may be given IV or IM.

What is oxytocin?

500
Consider in cases of HELLP, abruption, prolonged IUFD, sepsis, or amniotic fluid embolism.
What is coagulopathy?