Single pad is 30ml
How to estimate blood loss?
Completely soaked is 50ml
Blood flow in etrine artery at this point is 500ml
If tricking down the bed can be 100 ml
Why catheterise the bladder ....1 urinary retention can intefer wiith it 2. shock so helps with monitoring urine output
What to do if PPH is suspected?
condom catheter = foley catheter attached to condom
Pelvic pressure pack also called parachte packing
uterine packing is not recommended as can case increase chances of infection and sepsis
must rule out genital tract tract trama if uterus is contracted!
epis is like a 2nd degree perineal tear.
what about hemotomas and cervical tears ad other labour genital tract trauma?
4th degree...you can have a fistula even!
If fresh and no natural healing yet and inflammation..that is before 24 hours and in the labour room then can repair immedietely...but if found later with reepithelisation and healing and inflammation, must wait till this is sbsides and normalised and then intevene and repair. because otherwise if you repair midway during the natural healing and infllmation process then very hard to predict how it would heal like. rather wait till natral completion and then intervene so its more predictable and less chance for failures.
when repairing tears in the stool in the labour room like s=epis tears etc...make sure you do a full vaginal and cervical explration..to see that you repaired and sutured all tears and wounds.... otherwise will start bleeding again in the future.
Causes of pph ⇒ for trauma remmeber the types of trauma > hemotomas, perinial and cervical tears
retained placental bits causes bleeding by making the uterus temporarily atonic. and so will case vaginal bleeding if thats the real cause
So how to identify PPH (clinically and by measuring vitals) and then find out the cause of PPH???
Hemtomas can be genital hemotomas as in near the epis or vaginal or be borad ligament hemotomas o
vaginal hemotmas are more common so first look for that before looking for broad ligament hemotomas?
How to manage PPH and uterine inversion both together. Cause of PPH is uterine inversion so do treat the cause!
Do johnsons method only once and then take to OT and do hydrotsattis
PPH
Manual removal of the placenta
