Obstetric Haemorrhage
Obstetric Haemorrhage: Overview
Vignette: Obstetric Haemorrhage
Question 1: History
Focussed History: Antepartum Haemorrhage
Examination
Question 2: Antepartum Haemorrhage (APH)
Question 3: Mrs G
Placental Abruption
Differential Diagnosis for APH
Images of some of the causes of APH
Placental Abruption vs. Placenta Praevia vs. Uterine Rupture
Question 4: Immediate Management
Group and Save vs. Cross-Match
Question 5: Taking BTS samples
Further Management
Delivery
Question 6: Postpartum Haemorrhage (PPH)
Anaemia: Reducing the Risk Antenatally
Question 7: Blood Loss 1
Question 8: Blood Loss 2
Postpartum Haemorrhage (PPH)
Estimating Blood Loss
Question 9: Estimating Blood Loss
Blood Options 1
Blood Options 2
Question 10: PPH
Question 11: Causes of PPH: The 4 T's
Postpartum Haemorrhage (PPH) contd.
Question 12: Drug Options
Tone: Mechanical and Pharmacological measures
Next Steps: Resort to Surgical Measures if Phamacological Measures Fail to Control Bleeding
Trauma
Tissue
Thrombin
Disseminated Intravascular Coagulation (DIC)
Management of Major PPH and Ongoing Bleeding: Replace, Stabilise and Stop the Source of Bleeding
Pin Girl - PPH Management Overview
Question 13: Blood Tubes
Why Check Bloods?
Mrs G
Post Bleed Care
Debrief
Risk Management
Question 14: End of Case Quiz
References and Resources
Feedback
Obstetric Haemorrhage
Pin Girl - PPH Management Overview
UTERUS
Start Here & CALL FOR HELP
Fundal massage, bi-manual compression
Urinary catheter
Review oter causes: 4 T's
ARMS
Check observations
IV access (wide bore) x 2
Bloods: FBC / clotting / cross-match
4 units
Fluid resuscitation (warmed)
Uteronic drugs
HEAD
Airway
Breathing
Oxygen
Lie flat
Documentation / Scribe
