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