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    Post Partum Haemorrhage

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    Wafiyah Awais
    This document provides an overview of postpartum haemorrhage (PPH). It defines PPH as blood loss over 500 ml within 24 hours of delivery (primary) or 24 hours to 6 weeks postpartum (secondary). PPH is a leading cause of maternal death in developing countries like Pakistan. The lecture objectives are to define PPH, identify causes, and describe management. Causes include uterine atony, trauma, retained tissue, and coagulopathy. Management involves resuscitation, treating the underlying cause through interventions like uterotonic drugs, compression, exploration, and in severe cases, artery ligation or hysterectomy. Prevention relies on active management of the third stage of labour.

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    Post Partum Haemorrhage

    Uploaded by

    Wafiyah Awais
    13 views27 pages
    This document provides an overview of postpartum haemorrhage (PPH). It defines PPH as blood loss over 500 ml within 24 hours of delivery (primary) or 24 hours to 6 weeks postpartum (secondary). PPH is a leading cause of maternal death in developing countries like Pakistan. The lecture objectives are to define PPH, identify causes, and describe management. Causes include uterine atony, trauma, retained tissue, and coagulopathy. Management involves resuscitation, treating the underlying cause through interventions like uterotonic drugs, compression, exploration, and in severe cases, artery ligation or hysterectomy. Prevention relies on active management of the third stage of labour.

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    This document provides an overview of postpartum haemorrhage (PPH). It defines PPH as blood loss over 500 ml within 24 hours of delivery (primary) or 24 hours to 6 weeks postpartum (secondary). PPH is a leading cause of maternal death in developing countries like Pakistan. The lecture objectives are to define PPH, identify causes, and describe management. Causes include uterine atony, trauma, retained tissue, and coagulopathy. Management involves resuscitation, treating the underlying cause through interventions like uterotonic drugs, compression, exploration, and in severe cases, artery ligation or hysterectomy. Prevention relies on active management of the third stage of labour.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    13 views27 pages

    Post Partum Haemorrhage

    Uploaded by

    Wafiyah Awais
    This document provides an overview of postpartum haemorrhage (PPH). It defines PPH as blood loss over 500 ml within 24 hours of delivery (primary) or 24 hours to 6 weeks postpartum (secondary). PPH is a leading cause of maternal death in developing countries like Pakistan. The lecture objectives are to define PPH, identify causes, and describe management. Causes include uterine atony, trauma, retained tissue, and coagulopathy. Management involves resuscitation, treating the underlying cause through interventions like uterotonic drugs, compression, exploration, and in severe cases, artery ligation or hysterectomy. Prevention relies on active management of the third stage of labour.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 27

    Post Partum Haemorrhage

    Dr Nayyer Sultana
    Associate Professor
    Obstetrics & Gynaecology
    CPMC
    Learning Objectives
    At the end of the lecture the students will be able to:

    • Define postpartum haemorrhage(PPH).


    • List the causes of PPH.
    • Describe the management plan of PPH.
    Definition

    Primary postpartum haemorrhage


    Loss of more than 500 ml of blood within 24 hours of
    delivery of the baby.

    Secondary postpartum haemorrhage


    Loss of more than 500 ml of blood after 24 hours of
    delivery till 6 weeks postpartum.
    Why to know about PPH?

    Postpartum haemorrhage is the leading cause of

    maternal death in developing countries like Pakistan.


    Maternal mortality rate

     Pakistan
    178/100,000 live birth

     USA ˡ
    23/100,000 live births
    Maternal mortality rate

     United Kingdom
    7/100,000 live births

     Ireland²
    zero in 2019
    1643
    32 billion rupees
    1739³
    Active management of third
    stage of labour
     Uterotonic drugs
     Controlled cord traction.
     Uterine massage.

    Purpose
    • Prevention of postpartum haemorrhage
    Causes of PPH

    4 Ts

    • Tone: Uterine atony


    • Trauma: Lacerations or genital tract tears
    • Tissue: Retained placenta
    • Thrombin: Coagulopathy
    Management

     Resuscitation

     Treatment of the underlying cause


    Resuscitation
    Resuscitation

     Airway

     Breathing

     Circulation
    Resuscitation
    Resuscitation
    Resuscitation
    Investigations

    • Blood grouping & Rh Factor

    • Blood & blood products

    • CBC

    • Coagulation profile
    Treatment of the Cause

     Bimanual uterine compression

     Uterotonic drugs
    Bimanual uterine compression
    Treatment of the Cause

     Examination under anaesthesia

     Stitching of genital tract injury

     Exploration of uterus
    Balloon Tamponade
    Uterine Compression Suture
    Treatment of the cause

     Uterine artery ligation

     Internal iliac artery ligation

     Hysterectomy
    References
    1. Murphy SL, Kochanek KD, Xu JQ, Arias E. Mortality in the United
    States, 2020. NCHS Data Brief, no 427. Hyattsville, MD: National
    Center for Health Statistics. 2021.

    2. https://www.cso.ie/en/releasesandpublicatios/irelandsunsdgs2019report

    3. Ryan, Thomas (1885). The history of Queen Charlotte Lying-in


    Hospital.pp. ix–xv.

    4. John F O'Sullivan. Two hundred years of midwifery 1806-2006.Ulster


    Med J. 2006 Sep; 75(3): 213–222.

    5. Textbook of Obstetrics by Ten Teachers


    [email protected]

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