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POST-PARTUM HAEMORRHAGE
&
AMTSL
What is PPH
 AN EMERGENCY !!!
 Traditional definition:
 >500 ml after Vaginal delivery
 >1000 ml after LSCS
 How to measure blood loss ??
The Why of PPH
 Retraction & Involution
 Timing of bleeding:
 Primary
 Secondary
 Factors involved:
 4 T's
How do we manage
 Call for help
 ABC
 HAEMOSTASIS
 H: ask for Help
 A: Assess vitals & resuscitate
 E:
 Establish cause
 Ecbolics / uterotonics
 Ensure blood
 M: Massage (bimanual)
 O: Oxytocin infusion
 S: Shift to OT
 T: Tamponade
 Pneumatic anti-shock garment
 Bhakri Balloon
 A: Apply compression sutures
 S: Systemic devascularisation
 I: Interventional radiology
 S: Subtotal/Total Hysterectomy
Measuring Blood Loss
 Visual
 Accurate counts
 Hematocrit
Prevention of PPH
 Assessing risk factors
 Active Management of Third Stage of Labour
(AMTSL)
 Recognising and Diagnosis
 Drills....
 And more drills
AMTSL
PPH-AMTSL.ppt

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PPH-AMTSL.ppt

  • 2.
  • 3. What is PPH  AN EMERGENCY !!!  Traditional definition:  >500 ml after Vaginal delivery  >1000 ml after LSCS  How to measure blood loss ??
  • 4. The Why of PPH  Retraction & Involution  Timing of bleeding:  Primary  Secondary
  • 5.
  • 7.
  • 8. How do we manage  Call for help  ABC  HAEMOSTASIS
  • 9.  H: ask for Help  A: Assess vitals & resuscitate  E:  Establish cause  Ecbolics / uterotonics  Ensure blood
  • 10.  M: Massage (bimanual)  O: Oxytocin infusion  S: Shift to OT  T: Tamponade  Pneumatic anti-shock garment  Bhakri Balloon
  • 11.
  • 12.
  • 13.  A: Apply compression sutures  S: Systemic devascularisation  I: Interventional radiology  S: Subtotal/Total Hysterectomy
  • 14.
  • 15. Measuring Blood Loss  Visual  Accurate counts  Hematocrit
  • 16.
  • 17. Prevention of PPH  Assessing risk factors  Active Management of Third Stage of Labour (AMTSL)  Recognising and Diagnosis  Drills....  And more drills
  • 18. AMTSL