Postpartum Hemorrhage Test Questions and Answers Rated A
most common cause of postpartum hemorrhage-
-uterine atony
4 T's that can cause early postpartum hemorrhage-
-1. tone
Where does detachment of the placenta normally 2. trauma
occur first from the uterine wall?- -starts at 3. tissue
center and works its way toward the periphery 4. thrombin (failure of blood to clot normally)
How is the uterine bleeding stopped after the most common cause of early post-partum
placenta detaches- -"criss-crossing" muscle hemorrhage- -tone (atony)
cells encircling the maternal spiral arteries contract
What does the uterus feel like with atony?- -soft
post-partum hemorrhage- -delivery-associated and boggy
blood loss in excess of *500mL* for a vaginal delivery
and in excess of *1,000 mL* for a c/s
trauma that can cause early PPH (3)- -1. genital
tract lacerations
primary (early) PPH- -within 25 hours of 2. uterine inversion
delivery 3. uterine rupture
secondary (late) PPH- -occurs >24 hours but tissue cause of early PPH- -retained placenta
within 12 weeks after delivery ("saturating a pad
within an hour")
How can a retained placenta cause PPH- -if
only part of the placenta detaches, the part that's left
Is early or late post-partum hemorrhage more can prevent the uterus from contracting completely --
worrisome?- -early > uterus that doesn't contract well can cause
hemorrhage
prevalence of post-partum hemorrhage- -4%
What increases the risk of atony? (6)- -1.
prolonged labor
At what percent of blood loss in PPH, will a woman 2. labor augmented by oxytocin
start developing signs?- -20% 3. rapid labor
4. over-distended uterus
5. MgSO4 treatment
clinical signs of 10-15%, 20%, 30%, and 40-50% 6. chorioamnionitis
blood loss with PPH- -10-15%: no signs
(1 and 2 wear the uterus out)
20%: tachycardia, delayed capillary refill, orthostatic
changes, narrowed pulse pressure
What causes trauma to the uterus causing early
30%: breathing and HR further increases, overt PPH? (4)- -1. mediolateral episiotomy
hypotension develops 2. forceps/vacuum delivery
3. macrosomnia
40-50%: oliguria, shock, coma...death 4. nonvertex presentation
1/4
most common cause of postpartum hemorrhage-
-uterine atony
4 T's that can cause early postpartum hemorrhage-
-1. tone
Where does detachment of the placenta normally 2. trauma
occur first from the uterine wall?- -starts at 3. tissue
center and works its way toward the periphery 4. thrombin (failure of blood to clot normally)
How is the uterine bleeding stopped after the most common cause of early post-partum
placenta detaches- -"criss-crossing" muscle hemorrhage- -tone (atony)
cells encircling the maternal spiral arteries contract
What does the uterus feel like with atony?- -soft
post-partum hemorrhage- -delivery-associated and boggy
blood loss in excess of *500mL* for a vaginal delivery
and in excess of *1,000 mL* for a c/s
trauma that can cause early PPH (3)- -1. genital
tract lacerations
primary (early) PPH- -within 25 hours of 2. uterine inversion
delivery 3. uterine rupture
secondary (late) PPH- -occurs >24 hours but tissue cause of early PPH- -retained placenta
within 12 weeks after delivery ("saturating a pad
within an hour")
How can a retained placenta cause PPH- -if
only part of the placenta detaches, the part that's left
Is early or late post-partum hemorrhage more can prevent the uterus from contracting completely --
worrisome?- -early > uterus that doesn't contract well can cause
hemorrhage
prevalence of post-partum hemorrhage- -4%
What increases the risk of atony? (6)- -1.
prolonged labor
At what percent of blood loss in PPH, will a woman 2. labor augmented by oxytocin
start developing signs?- -20% 3. rapid labor
4. over-distended uterus
5. MgSO4 treatment
clinical signs of 10-15%, 20%, 30%, and 40-50% 6. chorioamnionitis
blood loss with PPH- -10-15%: no signs
(1 and 2 wear the uterus out)
20%: tachycardia, delayed capillary refill, orthostatic
changes, narrowed pulse pressure
What causes trauma to the uterus causing early
30%: breathing and HR further increases, overt PPH? (4)- -1. mediolateral episiotomy
hypotension develops 2. forceps/vacuum delivery
3. macrosomnia
40-50%: oliguria, shock, coma...death 4. nonvertex presentation
1/4
