Massive Obstetric Hemorrhage - Health Research at Fernandez ...

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5000 4000 3000 2000 1000 0 2830 Deliveries Fernandez Hospital 3080 3342 3874 4408 4715 2003 2004 2005 2006 2007 2008 Deliveries
Labour Epidural Analgesia Dedicated OCCU Dedicated acute Pain service PAC Clinic Anaesthesia Services Fellowship and post doctoral training courses
Page 1 and 2: Massive Obstetric Hemorrhage Manage
Page 3: HOSPITAL Dedicated wholly to Women
Page 7 and 8: Massive Obstetric Hemorrhage “Obs
Page 9 and 10: Maternal mortality in India: WHO st
Page 11 and 12: • 585000 maternal deaths per year
Page 13 and 14: Obstetrical Hemorrhage Blood loss a
Page 15 and 16: The position of a woman in any civi
Page 17 and 18: Major Obstetric Haemorrhage As an A
Page 19 and 20: Admission Conscious, incoherent D
Page 21 and 22: Simultaneous Team Work History Taki
Page 23 and 24: Emergency Treatment IM Carboprost
Page 25: Lab Results Haemoglobin Undetectabl
Page 28 and 29: SURVIVING BLOOD LOSS
Page 30 and 31: Categorization of Acute Hemorrhage
Page 32 and 33: Remember… Blood Loss % Loss Respo
Page 34 and 35: Resuscitation • 2 large bore IV c
Page 36 and 37: Targets of Resuscitation Mental sta
Page 38 and 39: Platelet depletion Factor depletion
Page 40 and 41: Obstetric Hemorrhage Pathophysiolog
Page 42 and 43: Fluid Choices Fluid Type Comments N
Page 44 and 45: Very important to maintain adequate
Page 46 and 47: Severe Ongoing Hemorrhage Worsening
Page 48 and 49: Aim to Maintain • Adequate intrav
Page 50 and 51: The Trigger… Blood & Blood Compon
Page 52 and 53: Diagnosis of Coagulopathy Activatio
Page 54 and 55:
Packed Cell Transfusion • PRB‟c
Page 56 and 57:
Intra - Op Findings • Uterus enla
Page 58 and 59:
Post Operative - Findings • Oozin
Page 60 and 61:
Post Op Period - Stormy Prevent MOD
Page 63 and 64:
Post Op Period Weaned off ventilato
Page 65 and 66:
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 120 and 121:
Protocol Prevention • Active mana
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
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