Primary postpartum haemorrhage (PPH) is defined as blood loss > or = 500 mL, within 24 hours of delivery.
|
|
|
|
|
|
|
|
|
Aetiology
|
1. Tone - uterine atomy
|
2. Trauma - genital tract trauma
|
3. Tissue - retained placenta
|
4. Thrombin - coagulopathy
|
An EMPTY, CONTRACTED, INTACT uterus will not bleed in the absence of COAGULOPATHY
|
|
|
|
|
| | | | Grand Multiparity
Multiple pregnancy
Polyhydraminos
Macrosomia
Abnormalities: fibroids
Prolonged labour
Precipitate labour
Dysfunsctional labour
Intrauterine infection
Uterine relaxing agents
(Magnesium / general anaesthetic/ tocolytics)
|
| Operative delivery
Cervical / vaginal lacerations
Previous caesarean section increases risk of morbidly adherent placenta
|
| Retained placental tissue
|
| Pre-eclampsia
HELLP Syndrome
Placental abruption
FDIU>4/52
Amniotic Fluid Embolism
Sepsis
Bleeding disorders
Drugs (aspirin / heparin)
|
|
|
|
 |
|
Preventative management
|
|
- Detect and treat antenatal anaemia
|
- Active management of third stage
|
- IV access plus collect blood for group and cross match if assessed as at risk
|
|
Consequences of PPH
|
|
|
|
|
|
|
|
|
|
|
Management
|
|
|
Audit
|
|
|
|
Royal Women's Hospital Clinical Practice Guidelines (CPGs) are intended to provide guidance to health care professionals, based on a thorough evaluation of research evidence, on the practical assessment and management of specific clinical issues or situations. The guidelines allow some flexibility on the part of the health care professional based on the needs of the specific patient for whom they are caring.
|
Please remember to read our disclaimer.
|
