PPH

Question 1

list RF for PPH

Answer 1

APH, PAS, prev PPH, multiple, PET, macrosomia, BMI >35

Question 2

list the 4 T’s and assoc 4 R’s

Answer 2

TONE- RUB
TRAUMA - REPAIR
TISSUE - REMOVE
THROMBIN- REPLACE

Question 3

list actions for PPH management

Answer 3

deliver plac via active management, fundal rub, call for help, obs and 5mnly, O2, flatten bed, IV and bloods, increase synto and fluid rate, check for trauma/tissue, miso, IDC, blood clotting or no, TXA/carboprost, examine placenta, consider bimanual compression, consider corticosteroids/ mag sulf/ anti D

Question 4

list meds and dosages

Answer 4

synto active management 10iu IM
synto 30iu in 500ml normal saline 167ml/hr
misoprostol 800-1000mcg PR
TXA 1g over 10mns
carboprost 250mcg IM
ergometrine 250mcg IM if not CI