Massive Obstetric Hemorrhage - Health Research at Fernandez ...

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Post Op Period Weaned off ventil<strong>at</strong>ory supports Shifted to ward on 8 th POD Drains removed on 10 th POD Discharged on 14 th Post Op Day
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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
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 64 and 65: Total Blood Products - 113 Packed C
Page 66: Hospital Protocol Having systems in
Page 69 and 70: Bimanual Compression
Page 71 and 72: Surgical Management • Tamponade
Page 73 and 74: The Best One is Probably the One th
Page 75 and 76: Uterine Tamponade
Page 77 and 78: Compression Sutures B Lynch Hayman
Page 79 and 80: B- Lynch Suture
Page 81 and 82: Cho‟s Sutures
Page 83 and 84: Step by Step De-vascularization
Page 85 and 86: Internal Iliac Artery Ligation
Page 87 and 88: 20 weeks Ultrasound in Fernandez
Page 89 and 90: Peripheral shut down!!
Page 91 and 92: Resuscitated • Re-opened at 7 am,
Page 93 and 94: Abdominal / Vaginal Packing with Fa
Page 95 and 96: Discharged on 17 th POD • Packed
Page 97 and 98: Recombinant Factor VIIa • Cost :
Page 99 and 100: Recombinant Factor VIIa Our experie
Page 101 and 102: Recombinant factor VIIa: use in fat
Page 103 and 104: TECHNIQUE • BILATERAL FEMORAL ART
Page 107: TECHNIQUE • 7 MM BALLOONS WERE PL
Page 111 and 112: Reducing Mortality and Morbidity
Page 113 and 114:
Alternatives to Transfusion Therapy
Page 115 and 116:
Recognition of Risk Factors Anticip
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Diagnosis in antepartum period •
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Multidisciplinary Team • Consulta
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Goals • Early institution of mass
Page 126 and 127:
The Uterotonic Drugs
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5000 4000 3000 2000 1000 Number of
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Massive Obstetric Hemorrhage is a P
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