Lowdermilk Chapter 33 Postpartum Complications.

Lowdermilk Chapter 33 Postpartum Complications
sd sd sd sd




PPHsd-sdcorrectsdanswer✔ ✔ PostpartumsdHemorrhage

-leadingsdcausesdofsdmaternalsdmorbiditysdandsdmortality
-
losssdofsd500sdmLsdorsdmoresdofsdbloodsdaftersdvaginalsdbirthsdorsd1000sdmLsdorsd
moresdofsdbloodsdaftersdC-sectionsd
-
Definedsdalsosdbysdasd10%sddecreasesdinsdhematocritsdbetweensdadmissionsdfors
dlaborsdandsdpostpartum




Early/Acute/PrimarysdPPHsd-sdcorrectsdanswer✔ ✔
Occurssdwithinsd24sdhourssdofsdbirth



Late/SecondarysdPPHsd-sdcorrectsdanswer✔ ✔
Occurssdmoresdthansd24sdhourssdbutsdlesssdthansd6sdweekssdaftersdbirthsd
-resultsdofsdsubinvolutionsdofsdthesduterus,sdendometritis
-retainedsdplacentalsdfragments



Brightsdbloodsd-sdcorrectsdanswer✔ ✔ Arterial

-cansdindicatesddeepsdlacerationssdofsdthesdcervix

,Darksdredsdbloodsd-sdcorrectsdanswer✔ ✔ Venous

-couldsdbesdfromsdvaricessdorsdsuperficialsdlacerationssdofsdbirthsdcanal


Whensdcansdexcessivesdbleedingsdoccur?sd-sdcorrectsdanswer✔ ✔
Duringsdthesdperiodsdbetweensdthesdseparationsdofsdthesdplacentasdandsditssdex
pulsion/removal
-
duesdtosdincompletesdplacentalsdseparation,sdunduesdmanipulationsdofsdthesdfun
dus,sdorsdexcessivesdtractionsdonsdthesdcord


UterinesdAtonysd-sdcorrectsdanswer✔ ✔
Thesdgreatestsdrisksdforsdearlysdpostpartumsdhemorrhagesd(esp.sdwithinsdfirsts
dhoursdaftersdbirth)sd



-
occurssdwhensduterussdissdflaccidsdaftersddetachmentsdofsdallsdorsdpartsdofsdthesdpl
acenta
-hypotoniasdofsdthesduterussd
-uterussdfeelssdboggysd(soft)


WhatsdissdthesdleadingsdcausesdofsdearlysdPPH?sd-sdcorrectsdanswer✔ ✔
Uterinesdatony

,CausessdofsdUterinesdAtonysd-sdcorrectsdanswer✔ ✔
Overdistendedsduterus
-Traumaticsdbirth
-Highsdparity
-Polyhydramnios
-Fetalsdmacrosomia
-Mulitplesdgestations
-Magnesiumsdsulfate
-Rapidsdorsdprlongedsdlabor
-Chorioamnionitis
-Usesdofsdoxytocinsdforsdlaborsdinduction
-uterinesdatonysdinsdasdprevioussdpregnancysd
-anesthesiasdandsdanalgesiasd
-forceps-assistedsdbirth
-Vacuum-assitedsdbirthsd
-retainedsdplacentalsdfragmentssd
-inversionsdofsdthesduterus
-rupturedsduterus
-placentasdaccreta,sdincreta,sdpercreta
-placentalsdabruption
-placentasdprevia

, -uterinesdsubinvolution


RetainedsdPlacentasd-sdcorrectsdanswer✔ ✔ -
Whensdthesdplacentasdhassdnotsdbeensddeliveredsdwithinsd30sdminutessdaftersdbir
thsddespitesdgentlesdtractionsdonsdumbilicalsdcord


Whatsdissdthesdinitialsdmanagementsdofsdasdretainedsdplacenta?sd-
sdcorrectsdanswer✔ ✔ -ManualsdseparationsdandsdremovalsdbysdthesdHCP


Whatsdcansdbesdusedsdtosddiagnosesdretainedsdplacentalsdfragments?sd-
sdcorrectsdanswer✔ ✔ ultrasonography



PlacentasdAccretasd-sdcorrectsdanswer✔ ✔
Slightsdpenetrationsdofsdmyometriumsdbysdplacenta
-mostsdcommon


PlacentasdIncretasd-sdcorrectsdanswer✔ ✔
Deepsdpenetrationsdofsdmyometriumsdbysdplacenta


PlacentasdPercretasd-sdcorrectsdanswer✔ ✔ -
Perforationsdofsdthesduterussdbysdplacenta