1 / 9

Secondary postpartum haemorrhage

Secondary postpartum haemorrhage. -Secondary postpartum hemorrhage is any abnormal or excessive bleeding from the genital tract occurring between 24 hrs and 12 weeks postnatally. -It is most likely to occur between 10 and 14 days after birth.

mcaine
Télécharger la présentation

Secondary postpartum haemorrhage

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Secondary postpartum haemorrhage • -Secondary postpartum hemorrhage is any abnormal or excessive bleeding from the genital tract occurring between 24 hrs and 12 weeks postnatally. • -It is most likely to occur between 10 and 14 days after birth. • -Bleeding is usually due to retention of a fragment of the placenta or membranes, or the presence of a large uterine blood clot.

  2. -Typically : • -occurring during the second week • - the lochia is heavier than normal • - and will have changed from a serous pink or brownish loss to a bright red blood loss. • - The lochia may also be offensive if infection is a contributory factor.

  3. - Sub involution • - pyrexia • - tachycardia . • Management • • call a doctor • • reassure the woman and her support person(s) • • rub up a contraction by massaging the uterus if it is still palpable • • express any clots

  4. encourage the mother to empty her bladder • • give a uterotonic drug such as ergometrine maleate by the intravenous or intramuscular route • • keep all pads and linen to assess the volume of blood lost. • -The doctor, midwife or paramedic who attends will start an intravenous infusion and ensure that the mother's condition is stable first

  5. -Careful assessment is usually undertaken prior to the uterus being explored under general anaesthetic. • - The use of ultrasound as a diagnostic tool. • - If retained products of conception cannot be seen on a scan, the mother may be treated conservatively with antibiotic therapy and oral ergometrine. • -The hemoglobin should be estimated prior to discharge. • - If it is below 9 g/dL, options for iron replacement should be discussed with the woman.

  6. -increased intake of iron-rich foods, iron supplements or, in extreme cases, blood transfusion. • -It is also important to discuss the common symptoms that may be experienced as a result of anaemia following PPH, including extreme tiredness and general malaise. • -hemoglobin levels checked & monitored.

  7. Haematoma formation • -PPH may also be concealed as the result of progressive haematoma formation. • - sites : • -the perineum • - lower vagina • -broad ligament • - vault of the vagina. • -A large volume of blood may collect insidiously (up to 1 L). • - Involution and lochia are usually normal • - the haematoma has to be drained in theatre under a general anaesthetic. • -Secondary infection may occur.

  8. Care after a postpartum haemorrhage • -continues support • -partner reassurance. • -encourage breast-feeding

More Related