Post Partum hemorrhage

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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)

The post Post Partum hemorrhage first appeared on Critical Care Education.

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