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Massive Obstetric Hemorrhage Manage
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HOSPITAL Dedicated wholly to Women
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Labour Epidural Analgesia Dedicated
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Massive Obstetric Hemorrhage “Obs
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Maternal mortality in India: WHO st
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• 585000 maternal deaths per year
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Obstetrical Hemorrhage Blood loss a
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The position of a woman in any civi
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Major Obstetric Haemorrhage As an A
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Admission Conscious, incoherent D
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Simultaneous Team Work History Taki
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Emergency Treatment IM Carboprost
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Lab Results Haemoglobin Undetectabl
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SURVIVING BLOOD LOSS
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Categorization of Acute Hemorrhage
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Remember… Blood Loss % Loss Respo
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Resuscitation • 2 large bore IV c
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Targets of Resuscitation Mental sta
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Platelet depletion Factor depletion
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Obstetric Hemorrhage Pathophysiolog
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Fluid Choices Fluid Type Comments N
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Very important to maintain adequate
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Severe Ongoing Hemorrhage Worsening
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Aim to Maintain • Adequate intrav
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The Trigger… Blood & Blood Compon
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Diagnosis of Coagulopathy Activatio
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Packed Cell Transfusion • PRB‟c
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Intra - Op Findings • Uterus enla
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Post Operative - Findings • Oozin
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Post Op Period - Stormy Prevent MOD
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Post Op Period Weaned off ventilato
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Incidence PPH : 4 - 6 % of deliveri
- Page 68 and 69: Massage Uterus Protocol Soft Atonic
- Page 70 and 71: When Oxytocics Fail Medical managem
- Page 72 and 73: Choice of Procedure • Age & Parit
- Page 74 and 75: Uterine Tamponade • Gauge packing
- Page 76 and 77: Sengstaken Tube Condom Tamponade
- Page 78 and 79: B Lynch 2 1
- Page 80 and 81: Hayman‟s Sutures
- Page 82 and 83: De-vascularization Uterine Ovarian
- Page 84 and 85: Uterine / Ovarian Ligation
- Page 86 and 87: 32 years, 2 nd Pregnancy • G 2 P
- Page 88 and 89: 24 weeks, 4 am • Pain abdomen + b
- Page 90 and 91: Blood loss ?
- Page 92 and 93: Resuscitation Ongoing • Internal
- Page 94 and 95: II Post Op Day • Re-laparotomy (
- Page 96 and 97: Recombinant Factor VIIa • Life sa
- Page 98 and 99: FVIIa boosts thrombin generation on
- Page 100 and 101: Case 5 : Placenta Percreta with Mas
- Page 102 and 103: Radiological Interventions: Adheran
- Page 104: INFLATED BALLOON IN LEFT INTERNAL I
- Page 110 and 111: Retaining Placenta: Our experience
- Page 112 and 113: What Can be Done ? • Recognition
- Page 114 and 115: Complications of Massive Blood Tran
- Page 116 and 117: Recognition of Coagulopathy Anticip
- Page 122 and 123: • Call for help Communication Tea
- Page 124: Early Warning Obstetric Chart
- Page 127 and 128: 5000 4000 3000 2000 1000 0 Number o
- Page 129 and 130: The Practice Point Active communica
- Page 131: Life is no brief candle to me. It i