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Seminar On Complication of 3rd Stage PPH
Seminar On Complication of 3rd Stage PPH
Seminar On Complication of 3rd Stage PPH
Seminar
on
COMPLICATION OF 3rd
stage of labour
INCIDENCE:
Vaginal delivery is associated with a 3.9% incidence of postpartum
hemorrhage. Cesarean delivery is associated with a 6.4% incidence of postpartum
hemorrhage. Delayed postpartum hemorrhage occurs in 1-2% of patients.
ETIOLOGY:
Early postpartum hemorrhage
May result from
Uterine atony
Retained products of conception
Uterine rupture
Uterine inversion
Placenta accreta
Placental hypertrophy
Lower genital tract lacerations
Coagulopathy
Bleeding Disorder
Late postpartum hemorrhage
Retained products of conception
Infection
Subinvolution of placental site
Uterine atony and lower genital tract lacerations are the most common causes of
postpartum hemorrhage.
DIAGNOSIS:
The onset of postpartum hemorrhage is acute, intervention is immediate, and
resolution is generally within minutes; consequently, laboratory studies or imaging
in the management of the immediate course of this process has little role.
However, it is important to check a patient's
CBC count
Prothrombin time/activated partial thromboplastin time (PT/aPTT) to
exclude resulting anemia or coagulopathy, which may require further
treatment.
TREATMENT
Initial therapy includes
Uterine packing is now considered safe and effective therapy for the treatment
of postpartum hemorrhage. Use prophylactic antibiotics and concomitant
oxytocin with this technique. The timing of removal of the packing is
controversial, but most physicians favour 24-36 hours. This treatment is
successful in half of patients. If unsuccessful, it still provides time in which the
patient can be stabilized before other surgical techniques are employed.
Fig: Uterine packing Fig: Uterine artery Embolization
Complications are rare (6-7%) and include fever, infection, and nontarget
embolization.
Fig: Hysterectomy
NURSING MANAGEMENT
NURSING DIAGNOSIS
INTERVENTIONS:
2.Retained Placenta
Fever
Foul smelling discharge containing large tissue residue
Persistent bleeding
Severe cramps and contractions
Delay in milk production
DIAGNOSIS OF RETAINED PLACENTA:
A careful examination
In a few cases, doctor may not diagnose the missing part of the placenta.
But, when you begin to experience the symptoms after delivery, it signals
the retention.
Ultrasound scan to check for retained placental fragments in the womb.
BIBLIOGRAPHY: