Oseteoporosis prophylaxis OBSTETRICS Ante Partum Haemorrhage Risk factors Features Complications Managment Placenta Praevia Age, Higher parity, Third trimester PPH, Placenta USS scan at 20 (Placenta is wholly Multiple unprovoked PV Accreta, weeks follow up – or partially pregnancy, bleeding, Soft in third trimester if attached to lower Previous C/S, uterus, low placenta, uterine segment) Succenturiate Cephalic Cross-match blood, placental lobe, presentation is not Immediate C/S Smoking engaged Placental Pre-eclampsia, Bleeding and Renal failure, HB, Cross-match Abruption Abdominal trauma, constant abdo disseminated blood, clotting (placental smoking, cocaine pain, Uterus is hard intravascular screen, Urinalysis, attachment is use, lower and tender, coagulaton, PPH, Depending on disrupted by socioeconomic severity delivery of haemorrhage) group, external fetus as life saving cephalic version procedure for mother Vasa Praevia Kelihauer test on (velamentous PV blood, Fetus insertion of cord must be delivered and vessels lie over urgently to avoid internal os) exsanguination, Post Haemorrhage –Partum Risk factors Multiple Pregnancy Prolonged labour Grand Multip Previous PPH Polyhydramnios APH Fibroid uterus Uterine Uterus Failure of contraction of uterus Retained products after delivery Coagulation disorders Genital Tract Trauma Uterine Inversion From trauma to: Uterine Rupture Endometritis Preineum Vagina Persistent Molar pregnancy Cervix Prevention Treatment of anaemia in pregnancy Controlled cord traction for Clotting screen placental delivery Anticipation of possible PPH Clamping and cutting umbilical Active mx of third stage of labour cord Oxytocic drugs Management IV access Hb, platelets, clotting and
Oseteoporosis prophylaxis OBSTETRICS Ante Partum Haemorrhage Risk factors Features Complications Managment Placenta Praevia (Placenta is wholly or partially attached to lower uterine segment) Age, Higher parity, Multiple pregnancy, Previous C/S, Succenturiate placental lobe, Smoking Third trimester unprovoked PV bleeding, Soft uterus, Cephalic presentation is not engaged PPH, Placenta Accreta, USS scan at 20 weeks – follow up in third trimester if low placenta, Cross-match blood, Immediate C/S Placental Abruption (placental attachment is disrupted by haemorrhage) Pre-eclampsia, Abdominal trauma, smoking, cocaine use, lower socioeconomic group, external cephalic version Bleeding and constant abdo pain, Uterus is hard and tender, Renal failure, disseminated intravascular coagulaton, PPH, HB, Cross-match blood, clotting screen, Urinalysis, Depending on severity delivery of fetus as life saving procedure for mother Vasa Praevia (velamentous insertion of cord and vessels lie over internal os) Kelihauer test on PV blood, Fetus must be delivered urgently to avoid exsanguination, Post –Partum Haemorrhage Risk factors Multiple Pregnancy Grand Multip Polyhydramnios Fibroid uterus Prolonged labour Previous PPH APH Uterine Failure of contraction of uterus after delivery Genital Tract Trauma From trauma to: Preineum Vagina Cervix Uterus Retained products Coagulation disorders Uterine Inversion Uterine Rupture Endometritis Persistent Molar pregnancy Prevention Treatment of anaemia in pregnancy Clotting screen Anticipation of possible PPH Active mx of third stage of labour Oxytocic drugs Controlled cord traction for placental delivery Clamping and cutting umbilical cord Management IV access Hb, platelets, clotting and
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