Does postpartum hemorrhage require surgery?

INTRODUCTION Postpartum hemorrhage (PPH) is an obstetric emergency with many potentially effective medical and surgical interventions for management (table 1).

What are the most important risk factors for postpartum hemorrhage?

Conditions that may increase the risk for postpartum hemorrhage include the following:

• Placental abruption. The early detachment of the placenta from the uterus.
• Placenta previa.
• Overdistended uterus.
• Multiple pregnancy.
• Gestational hypertension or preeclampsia.
• Having many previous births.
• Prolonged labor.
• Infection.

What are the 4 T’s associated with PPH?

As a way of remembering the causes of PPH, several sources have suggested using the “4 T’ s” as a mnemonic: tone, tissue, trauma, and thrombosis.

Which drug is contraindicated in PPH?

Any of the uterotonic drugs (ergometrine, oxytocin and prostaglandins) can be given together or sequentially for treatment of PPH. Ergometrine is contraindicated in women with a history of hypertension, heart disease, pre- eclampsia, or eclampsia.

What is the role of surgery in the treatment of PPH?

If bleeding continues after medical therapies for PPH, then surgical techniques that decrease uterine blood flow and pulse pressure can help decrease blood loss, thus giving time to allow for normal physiological and/or medical involution (uterotonics) to take effect.

What is surgical management of PPH?

Conservative surgical management in PPH includes surgical procedures that can avoid hysterectomy and its morbidity, as well as can preserve patient’s fertility. The most used procedures are the hemostatic sutures, which refer to the ligation of pelvic vessels (LPV) and uterine compressive sutures (UCS).

What makes you high risk for PPH?

Results: Major independent risk factors for PPH included primiparity, prior Caesarean section, placenta previa or low-lying placenta, marginal umbilical cord insertion in the placenta, transverse lie, labour induction and augmentation, uterine or cervical trauma at delivery, gestational age < 32 weeks, and birth weight …

What increases risk for PPH?

Pre-pregnancy and pregnancy-induced hypertension, transverse or compound presentation, abnormal placenta, prior Caesarean section, preterm birth, high birth weight, nulliparity, multiparity, uterine or cervical trauma during delivery, and placenta previa or low-lying placenta remained significantly associated with the …

What are the three main principles of the treatment of a PPH?

The treatment of patients with PPH has 2 major components: (1) resuscitation and management of obstetric hemorrhage and, possibly, hypovolemic shock and (2) identification and management of the underlying cause(s) of the hemorrhage.

What are risk factors for PPH?

Why is Cytotec given for postpartum hemorrhage?

Misoprostol is another prostaglandin that increases uterine tone and decreases postpartum bleeding. 36 Misoprostol is effective in the treatment of postpartum hemorrhage, but side effects may limit its use. 28,37 It can be administered sublingually, orally, vaginally, and rectally.

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