KUHS Essay Discussion

Dr GAYATHRI MS , MBBS, MD AIIMS DELHI, DNB, MRCOG , FMAS

 1)Question -
• De ne

• Classify.

• Risk factors factors.

• Causes

• Management.

• Active management of third stage of labour.

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 De nition

• Bleeding from genital tract

• -> 500 ML after vaginal delivery, >1000 ML after cesarean section

• >1000 regardless of mode of delivery

• Other de nitions-fall in Hematocrit of 10 % from antepartum level

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 Classi cation

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 Causes-4T

• Tone-uterine agony -80%

• Tissue - retained tissue or clots

• Trauma- genital tract injury

• Thrombin- coagulopathy
Risk factors
Risk factors
Management
Management
 Active management of third stage of labour -
WHO recommendation 2012

• Use of uterotonics-preferably oxytocin immediately after birth of baby

• Controlled cord contraction to deliver placenta-

• Postpartum abdominal uterine tone assessment- for early identi cation of uterine atony

• Uterine massage- -not recommended

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