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Post Partum hemorrhage

Dr Swapnil Pawar September 11, 2022 180


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    Post Partum hemorrhage
    Dr Swapnil Pawar

 

 

Post-Partum Haemorrhage

Blog written by – Dr Andrew Lam

 

Criteria for PPH:

  • Cumulative blood loss >1L OR bleeding with signs/symptoms of hypovolemia within 24 hours of delivery
  • Criteria remain the same, regardless of route of birth

Causes of PPH:

  • Uterine atony
  • Placental disorders (i.e. placenta praevia, placenta accreta, retained placenta, 
  • Trauma (i.e. vaginal tears, episiotomies, myometrial/uterine rupture)
  • Existing coagulopathy/bleeding diathesis

Management of PPH:

Supportive

  • Reversal of coagulopathy with blood products (i.e. Prothrombinex, FFP, cryoprecipitate, tranexamic acid)
  • Red blood cell transfusion with consideration of MTP

Definitive

  • Reversal of existing tears/rupture
  • Reversal of uterine atony (uterotonic agents, bimanual compression/massage)
  • Intra-uterine balloon (Bakri balloon)
  • Arterial embolisation
  • Surgical laparotomy (Uterine compression sutures, ligation of uterine arteries, hysterectomy)
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