TXA Trial for Post-Partum

of death due to post-partum ... tranexamic early in post-partum ... control, are the most

Causes of Post-Partum

Causes of Post-Partum ... Blood Loss: >500mL post ... delivery OR >1000 mL post

Atony (80%) - Most

Postpartum Hemorrhage - Differential Diagnosis, Examination and Management Uterotonic Medications (after delivery of the placenta): • Oxytocin (causes uterine contraction): 10 IU IM or 20 IU in 500 mL IV fluids at 250 mL/hr • RAPID IV INFUSION IS ASSOCIATED WITH CARDIOVASCULAR COLLAPSE • Methylergonovine (causes uterine contraction): 0.2 mg IM (avoid in preeclampsia or hypertension) • Carboprost (prostaglandin that induces uterine contraction: 0.25 mcg IM q15 min up to 2 mg (8 doses) • Misoprostol (prostaglandin that induces uterine contraction): 600-1000 mcg oral/rectal • OFF LABEL USE Methods of Tamponade: • Balloon uterine tamponade device (Bakri) • Foley catheter is not large enough to provide tamponade • Uterine packing may not be effective as the uterus may create and large potential space Surgical/Vascular Intervention: • Hysterectomy • Uterine Artery Embolization by Stacy Marshall, MD #Postpartum #Hemorrhage #Differential #Diagnosis #Examination #Management #Medications

Diagnosis and management of postpartum haemorrhage #Management #Diagnosis #EM #Obgyn #PostPartum #Hemorrhage #BMJ

Back to Basics: Postpartum Hemorrhage #Diagnosis #Management #Postpartum #Hemorrhage #PPH #4Ts #Differential

Precipitous Delivery and Postpartum Hemorrhage in the Emergency Department • Uncomplicated Delivery • Cephalic (head first) presentation & dystocia maneuvers • Breech presentations • Postpartum hemorrhage Dr. Reuben Strayer @emupdates #Precipitous #Delivery #Postpartum #Hemorrhage #Emergency #obstetrics #obgyn #algorithm #management #baby

Uterotonic Medications - Should be given concomitantly with uterine massage - Multiple medication options which increase uterine muscle tone #Management #Postpartum #Hemorrhage #Medications #Table #Uterotonic