Case Presentation

Post Partum Hemorrhage

By

Dr obot utin
I present Mrs J . C. U.

A 26 year old booked, nulliparous (now

P1+2)woman who presented to our facility on
account of labor pains and drainage of liqour
Following a brief history and examination

A diagnosis of Latent phase of labor was made

She was admitted, I.V access established with a wide

bore cannular

blood and urine samples were sent for investigation

Labor progressed
patient was delivered of a live male baby
following an Episiotomy.
baby weighed 3.82kg with apgar score of 8 at one
min and 9 at 5min.
Placenta was delivered by controlled cord
traction, weighing 550g. Cotyledons were
complete
After placenta was delivered, uterus was palpated
and was well contracted

further examination revealed that patient

sustained multiple vaginal laceration

Vaginal bleeding was noted to be in excess of

500mls
Other members of the medical team were alerted
Blood was requested for and set up immediately

Oxytocin infusion on opposite hand was ensured

Episiotomy and vaginal lacerations were repaired

Rectal misoprostol was inserted

Bleeding persisted after removal of vaginal
packs

The Cervix was examined with two sponge

holding forceps

A Cervical tear was noted at 9 O clock

position and it was immediately repaired
Estimated blood loss was 1.2ml

She was transfused with 4 unit of blood

She was discharged home on the 5th day post partum

on haematinics

PCV was 34%

Thank you