What is the management of postpartum hemorrhage?

Management of post-partum haemorrhage (PPH) involves the treatment of uterine atony, evacuation of retained placenta or placental fragments, surgery due to uterine or birth canal trauma, balloon tamponade, effective volume replacement and transfusion therapy, and occasionally, selective arterial embolization.

What are the 5 T’s of postpartum hemorrhage?

Differential Diagnosis of Postpartum Hemorrhage

There are four main causes of postpartum hemorrhage that account for the majority of cases. Also known as the “Four T’s”, these are Tone (uterine atony), Tissue (retained placenta), Trauma (laceration), and Thrombin (coagulopathy).

What four action domains are there for the management of postpartum hemorrhage?

Implementing these evidence-based safety bundles has been shown to demonstrate significant reductions in maternal morbidity. 2 The consensus bundle on obstetric hemorrhage is organized into four action domains: Readiness, Recognition and Prevention, Response, Reporting and Systems Learning.

What are the 4 R’s of obstetric hemorrhage?

Proposed Change. Through use of the 4 R’s process—readiness, recognition, response, and reporting/systems learning—we have analyzed our process for OBH management and identified and implemented improvements.

What are the 3 main causes of postpartum hemorrhage?

What causes postpartum hemorrhage?

  • Tear in the cervix or tissues of the vagina.
  • Tear in a blood vessel in the uterus.
  • Bleeding into a hidden tissue area or space in the pelvis. This mass of blood is called a hematoma. It is usually in the vulva or vagina.
  • Blood clotting disorders.
  • Placenta problems.

What are the 5 most common causes of PPH?

In many International and local studies it was revealed that the main cause of PPH is uterine atony followed by vaginal hematoma, cervical or vaginal tear, adherent placenta, uterine angle extension and retained placenta [3,5].

Which drug is contraindicated in PPH?

Any of the uterotonic drugs (ergometrine, oxytocin and prostaglandins) can be given together or sequentially for treatment of PPH. Ergometrine is contraindicated in women with a history of hypertension, heart disease, pre- eclampsia, or eclampsia.

What are four risk factors for PPH?

The risk factors for PPH were the use of ART, PIH, severe vaginal/perineal lacerations and having a macrosomic baby. The incidence of PPH in this study was higher than that reported previously. Sosa et al. reported that 10.8% of woman lost more than 500 ml and 1.9% lost greater than 1,000 ml [12].

Which drug is not used in PPH?

Tranexamic Acid
It is not recommended for prevention of PPH, due to lack of sufficient studies.

What is the #1 reason for PPH?

Uterine atony.
This is the most common cause of PPH. It happens when the muscles in your uterus don’t contract (tighten) well after birth. Uterine contractions after birth help stop bleeding from the place in the uterus where the placenta breaks away.

What is the first priority in management of postpartum hemorrhage?

External uterine massage and bimanual compression are generally used as first-line treatments. These compression techniques encourage uterine contractions that counteract atony and assist with expulsion of retained placenta or clots. Aortic compression is another compression technique that has been used for severe PPH.

What is another name for PPH?

Postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood following childbirth.

Postpartum bleeding
Other names Postpartum hemorrhage
A non-pneumatic anti-shock garment (NASG)
Specialty Obstetrics

What are the 4 most common causes of postpartum hemorrhage?

The Four T’s mnemonic can be used to identify and address the four most common causes of postpartum hemorrhage (uterine atony [Tone]; laceration, hematoma, inversion, rupture [Trauma]; retained tissue or invasive placenta [Tissue]; and coagulopathy [Thrombin]).

What are the preventive measures of PPH?

The main preventive measure for postpartum hemorrhage is the intramuscular administration of 10 units of oxytocin immediately after birth, associated with active management of the third stage.

What are the risk factors for PPH?

Conditions that may increase the risk for postpartum hemorrhage include the following:

  • Placental abruption. The early detachment of the placenta from the uterus.
  • Placenta previa.
  • Overdistended uterus.
  • Multiple pregnancy.
  • Gestational hypertension or preeclampsia.
  • Having many previous births.
  • Prolonged labor.
  • Infection.