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154x Tipe PPT Ukuran file 0.86 MB
Postpartum Complications: Principles • The most frequent cause of postpartum hemorrhage is uterine atony. • Anything that overdistends the uterus, causes it to contract poorly or overworks the uterus is a set-up for uterine atony. Postpartum Complications Postpartum Hemorrhage - Continues to be a leading cause of maternal morbidity and death in the US - Can occur with little warning - Definitions (PP lecture) * also include 10% drop in Hct between admission and postpartum - 50% underestimation of blood loss Postpartum Complications - Most common cause (90%) is uterine atony (marked hypotonia) - Less common causes are retained placenta, placenta accreta, cervical/vaginal lacerations, uterine rupture - Predisposing causes of uterine atony * Multiparity * Hydramnios * Macrosomic fetus * Traumatic birth * Rapid or prolonged labor Postpartum Complications * Use of magnesium sulfate * Use of oxytocin * Multiple pregnancy - Management of uterine atony * Manual massage of the uterus * Expression of clots * Eliminate bladder distention Postpartum Complications * IV of lactated Ringer’s or normal saline with 10-40 units of oxytocin added * Ergonovine or methyl-ergonovine (IM) if not hypertensive
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