Obstetrics: antepartum and postpartum hemorrhage, PPH management
Obstetrics and Gynecology · MBBS
Study notes
After delivery — 800ml bleeding, boggy uterus; atonic PPH; oxytocin, massage, fluids. PPH (primary <24h — atony commonest — 4 T's: Tone — atony; Trauma — tears; Tissue — retained; Thrombin — coagulopathy: manage — call help, oxytocin 10 IU, uterine massage, fluids/blood, empty bladder, balloon tamponade — Bakri; surgical — B-Lynch, artery ligation, hysterectomy): APH (previa — painless — placenta covers os — USG — C-section — no vaginal exam; abruption — painful, tender uterus, concealed — hypertension — deliver urgently; vasa previa — emergency). Prevention (AMTSL — oxytocin). The boggy uterus is atony — massage and oxytocin.
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