Intrapartum And Postpartum Complications; High Risk Newborn| From Question To Perfection| Study With Confidence!

INTRAPARTUM AND POSTPARTUM COMPLICATIONS;
HIGH RISK NEWBORN| FROM QUESTION TO PERFECTION|
STUDY WITH CONFIDENCE!

Course Code:
Course Title:
Programme:
Academic Year: 2026/2027
Duration: 2 Hours
Total Marks: 70%


Candidate Instructions:
1) Write your Registration Number on every answer booklet used.
2) Answer ALL questions in Section A and ANY TWO (2) questions in Section B.
3) Read each question carefully before answering.
4) Begin each question on a new page.
5) The marks for each question are indicated in brackets.
6) This paper consists of several printed pages, including this page.
7) Ensure your copy is complete before the examination begins.
8) Unauthorized materials and communication with other candidates are not permitted.




Turn Over.




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,postpartum hemorrhage Answer: -Leading cause of maternal death worldwide: this is why they
are 1 to 1
-more than:
500 ml of blood after vaginal birth; 1000 ml after cesarean birth
-Frequent fundal checks for the first 2 hours
Full assessment
early postpartum hemorrhage Answer: First 24 hours
From a laceration that did not get healed
late postpartum hemorrhage Answer: From 24 hours up to 6 weeks postpartum: more due to
subinvolution of the uterus or retained placental fragments
lacerations Answer: healed by suture
hematomas Answer: looks like a swollen bruise; happens in the perineal area or right above
your bladder; looks like a swollen bruise that is tender if the patient can feel down there; take a
skin marker and circle it so we can figure out if it is growing bigger or smaller; healed by
draining and repair
postpartum hemorrhage trauma management Answer: Involves repairing the trauma before
excessive blood loss occurs
Visualization of lacerations may be difficult
uterine atony Answer: -without tone
-uterus remains inadequately contracted
-press down and something would be squishy. Have to give it a massage to contract
uterine atony manifestations Answer: Fundus is difficult to locate
Boggy or soft feel to the fundus: feel something squishy or nothing at all; if you cannot find it,
start a fundal massage to get the uterus to contract; if not, assess if bladder needs to be empty,
give medications
-normal fundus feels hard
medications that contract the uterus Answer: Oxytocin
Methergine
Hemabate
cytotec
uterine atony management Answer: Measures to contract the uterus: medications


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, Oxytocin
Methergine
Hemabate
Cytotec
Provide fluid replacement
uterine atony risk factors Answer: Overdistention of the uterus
Multiparity (greater than 5)
Precipitate labor or delivery
Prolonged labor
Use of forceps or vacuum extractor
Cesarean birth
Manual removal of placenta
Uterine inversion
Placenta previa, accreta, or low implantation
induction/augmentation: pitocin (oxytocin)
General anestheisa
Chorioamnionitis
Clotting disorders
Previous postpartum hemorrhage or uterine surgery
Disseminated intravascular clotting
Uterine leiomyomas (fibroids)
uterine inversion Answer: Completely preventable event. If you are massaging really hard, you
can push the uterus outside of the patient. When you do checks, best practice is when you are
pushing down and you put a hand over the C section scar and add a little bit of light pressure.
When someone assesses the fundus and they do not put pressure down this happens so that is
why it is preventable.
PPH risk score Answer: when a patient comes in you ask if anone in the family has had a
hemorrhage, any bleeding or clotting disorders, what medications they are on. If they are
moderate or high risk, pull hemorrhaging meds (methergine, hemabate)
interventions for hemorrhage Answer: -PPH risk score
Early recognition is critical



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