Antepartum and Postpartum hemorrhage and complication in OB ppt Flashcards Preview

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Flashcards in Antepartum and Postpartum hemorrhage and complication in OB ppt Deck (18)
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1

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

peripartum hemorrhage

2

what is the primary mechanism for controlling blood loss at parturition

uterine contraction

3

3 main causes of antepartum hemorrhage

placentia previa
placental abruption
uterine rupture

4

should u do vag exams with placentia previa?

no way,
or performed under a double set up

5

what shoiuld anesthesia do to ALL women with placenta previa?

evaluate them early
2 large PIV
labs
volume resusitation

6

what is the most common cause of DIC

placenta abruption

7

management for abruption

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

8

what are better choices for induction in hypovolemia?

ketamine and etomidate

9

causes of postpartum hemorrhage

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

10

most common cause of postpartum hemorrhage?

uterine atony

11

1st line drug for uterine atony?

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

12

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

vasopressors
b/c it causes aplha-adrenergic stimulation

13

Post dural puncture h/a s/s

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

14

total CSF fluid

150 ml

15

treatment for PDPH

caffine
IV hydration
epidural blood patch

16

blood patch how is it done?

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

complications of LA injection into intravascular space

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

s/s of accidential subarachnoid injection

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