post partum hemmorrhage

1. POSTPARTUMHEMORRHAGE
Dr.hafsaasim

2. Pregnancy is the most
difficult journey

3. DEFINITION:
It is defined as blood loss of
more than 500 ml after vaginal
delivery and 1000 ml after
cesarean section

4. Types:
Antepartum
Hemorrhage
Primary Secondary
conception
22
week
Postpartum Hemorrhage
24hrs
12
week

5. Incidence & Mortality rate:WHO
 6-11% worldwide
 Africa 10.5% highest
 PPH accounts for 30%
of all maternal deaths
 529000 maternal
deaths/year in world
 8000/year in Pakistan

6. Causes of maternal mortality:
0
5
10
15
20
25
30

7. Causes of PPH:
tone70
trauma20
tissue10
thrombin01

9. PPH can be prevented by
active management of 3rd
stage of labour.

10. Initial Management:

11. Treatment protocol:Atonic PPH
shock Uterine
atony
management
Replacement of
blood
components
Medical
surgical

12. Uterine massage
Uterotonic drugs
Bimanualcompression
Aortic compression
Uterine
packing
tamponade
B lynch
Stepwise
uterine
devasculari
zation
Hysterectomy
Stepwise
management

13. Step
1

14. Uterine
massage
Uterotonic
drugs

15. Bimanual
uterine
compression
Aortic
compression

16. Step
2

17. Uterine
packing

18. Uterine
tamponade

19. Step
3

20. B lynch is a form of
compression suture
developed by Christopher
B-lynch in 1997
SUTURE MATERIAL:
1:vicryl 1 90cm
70mm(blunt,round body)
2:catgut 2

23. STEPWISE
DEVASCULARIZATION

26. POSTPARTUM
HYSTERECTOMY