Which procedure will help in the management of atonic PPH?
A new safety pin suture is a simple and effective procedure to control bleeding in patients with treatment-resistant, life-threatening atonic postpartum hemorrhage with the advantage of eliminating the risk of the sutures sliding off at the uterine fundus.
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 the first priority in management of postpartum hemorrhage?
External uterine massage and bimanual compression are generally used as first-line treatments. These compression techniques encourage uterine contractions that counteract atony and assist with expulsion of retained placenta or clots.
What is atonic PPH?
11.2 Atonic postpartum haemorrhage. The word ‘atonic’ means ‘loss of muscular tone or strength to contract’. Atonic postpartum haemorrhage is characterised by excessive bleeding when the uterus is not well contracted after the delivery, and is soft, distended and lacking muscular tone.
What are the four Ts in 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.
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).
How do you manage primary PPH?
The management of primary post-partum haemorrhage should include the simultaneous delivery of TRIM:
- Teamwork (Immediate Management)
- Resuscitation (Immediate Management)
- Investigations and Monitoring (Immediate Management)
- Measures to arrest bleeding (Definitive Management)
How is atonic PPH diagnosed?
The diagnosis of atonic postpartum hemorrhage was predominantly based on the estimated amount of blood loss, including blood clots and additional characteristics of bleeding.
What are the types of PPH?
Postpartum hemorrhage can be divided into 2 types: early postpartum hemorrhage, which occurs within 24 hours of delivery, and late postpartum hemorrhage, which occurs 24 hours to 6 weeks after delivery. Most cases of postpartum hemorrhage, greater than 99%, are early postpartum hemorrhage.
What is the reason of PPH?
Postpartum hemorrhage is heavy bleeding after the birth of your baby. Losing lots of blood quickly can cause a severe drop in your blood pressure. It may lead to shock and death if not treated. The most common cause of postpartum hemorrhage is when the uterus does not contract enough after delivery.
What causes PPH after C section?
Excessive haemorrhage associated with caesarean section, commonly defined as blood loss in excess of 1000 ml, is frequently underestimated, but is documented as occurring in more than 5-10% of caesarean sections. Common causes are uterine atony, abnormal placentation, uterine trauma and sepsis.