ACOG Postpartum Hemorrhage UPDATED ACTUAL Questions and CORRECT Answers

ACOG Postpartum Hemorrhage UPDATED
ACTUAL Questions and CORRECT
Answers
Maternal hemorrhage is defined as - CORRECT ANSWER - cumulative blood loss greater
than or equal to 1000 mL OR blood loss accompanied by signs or symptoms of hypovolemia
within 24 hoursafter the birth process (regardless of route)


Leading cause of maternal mortality - CORRECT ANSWER - PPH (requiring transfusion)



Secondary sequelae from PPH - CORRECT ANSWER - ARDS, shock, DIC, acute renal
failure, loss of fertility, and Sheehan syn


Despite new definition blood loss greater than ____ after a vaginal delivery is abnormal -
CORRECT ANSWER - 500 mL



First step: - CORRECT ANSWER - ID source of hemorrhage
-uterine
-cervical
-vaginal
-periurethral
-periclitoral
-perineal
-perianal
-rectal
(PE)


Primary vs secondary - CORRECT ANSWER - Primary within 24 hours of birth,
secondary >24 h and up to 12 wks postpartum

, Helpful way to evaluate a bleeding patient - CORRECT ANSWER - 4 Ts
-Tone
-Trauma
-Tisse
-Thrombin


Leading cause of PPH - CORRECT ANSWER - Uterine atony (70-80%)



Interventions for uterine atony - CORRECT ANSWER - massage, bimanual compression,
uterotonic drugs


MAternal truama includes - CORRECT ANSWER - lacerations, expanding hematomas,
uterine rupture


"Tissue" means/how to evaluate - CORRECT ANSWER - retained placenta/BSUS



Risk Factors for PPH: atony - CORRECT ANSWER - prolonged use of oxytocin
High parity
Chorio
General anesthesia
Multiple gestation
Polyhydramnios
Macrosomia
Multiple uterine fibroids
Excessive umb cord traction
Short umb cord
Fundal implantation of placenta