Postpartum hemorrhage28%)
heart diseases
pregnancy-induced hypertension
(or Amniotic fluid embolism )
infection
Definition of PPH
be defined as a blood loss exceeding 500ml
after delivery of the infant
Oxytocin agents
Methegine
prostaglandin
Mechanical stimulation of uterine contraction:
intrauterine packing
Surgical methods
If massage and agents are unsuccessful:
Ligation of the uterine arteries
ligation of the hypogastric arteries
selective arterial embolization
hysterectomy
taking into account the degree of
hemorrhage,the overall status of patient,her
future childbearing desires
2. Lacerations of the genital
tract
Causes:
Instrumented delivery (forceps)
manipulative delivery(breech
extraction,precipitous labor, macrosomia)
Types:
perineum laceration
vaginal laceration
cervical laceration
perineum and vaginal laceration
repair:
cervical laceration >2cm in length and be
actively bleeding
laceration of vaginal and perineum
3. Retained placenta
succenturiate placenta
Lab tests:
Hb,
BT(bleeding time), CT( clotting time),
platelets count
fibrinogen
prothrombin time and patial thromboplastin
time
FDP
womens group and cross-matching
Treatment:
the key is correcting the coagulation defect
resuscitation must be started as soon as possible
infusion of crystalloid(saline) and Dextran is
started firstly while arranging the blood
transfusion
blood transfusion is essential
infusion of platelets, fresh frozen plasma, FDP ,
clotting factors,
Potential complications of PPH:
Postpartum infection
Anemia
Transfusion hepatitis,
Sheehans syndrome
Ashermans syndrome