Antepartum and Postpartum hemorrhage and complication in OB ppt Flashcards

1
Q

what is the leading cause of maternal and fetal mobidity and mortality

A

peripartum hemorrhage

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2
Q

what is the primary mechanism for controlling blood loss at parturition

A

uterine contraction

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3
Q

3 main causes of antepartum hemorrhage

A

placentia previa
placental abruption
uterine rupture

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4
Q

should u do vag exams with placentia previa?

A

no way,

or performed under a double set up

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5
Q

what shoiuld anesthesia do to ALL women with placenta previa?

A

evaluate them early
2 large PIV
labs
volume resusitation

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6
Q

what is the most common cause of DIC

A

placenta abruption

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7
Q

management for abruption

A
FHR monitoring
2 large bore IVs
labs
O2
LUD
delivery
c-section??
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8
Q

what are better choices for induction in hypovolemia?

A

ketamine and etomidate

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9
Q

causes of postpartum hemorrhage

A
labor < 3 hr
intrument delivery
GA
prolonged labor
Macrosomia
Twins
choriamnionitis
Prior c-section
stimulated labor
Hx of postpartum hemorrhage
fetal demise
amniotic fluid embolus
tocolytic therapy
multiparity
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10
Q

most common cause of postpartum hemorrhage?

A

uterine atony

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11
Q

1st line drug for uterine atony?

A

oxytocin

20 units to 1000ml LR (may double to 40 units)

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12
Q

what must be avoided with use of methergine and why. (when used to contract uterus)

A

vasopressors

b/c it causes aplha-adrenergic stimulation

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13
Q

Post dural puncture h/a s/s

A

postural
photophobia
frontal-occipital in nature (dull throbbing)
diplopia
may not have immediate onset(12-48 hrs post)

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14
Q

total CSF fluid

A

150 ml

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15
Q

treatment for PDPH

A

caffine
IV hydration
epidural blood patch

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16
Q

blood patch how is it done?

A
same level or one beneath
15-20 mL of pt's blood
lie for one hour post supine
may repeat one
strict aseptic tech
17
Q

complications of LA injection into intravascular space

A
mubness tingling mouth
metallic taste
ringing in ears
seizure
CV collapse
(give test dose watch for HR to increase 30 beats in 30 sec)
18
Q

s/s of accidential subarachnoid injection

A

usually discovered with test dose (3-5 min)
total spinal signs
hypotension