4 T’s of life threatening post-partum hemorrhage

20 Oct
via the crashingpatient’s compilaton on some critical L&D emergencies:
 
Differential — 4 T’s:
 
TONE – uterine atony
TRAUMA – genital tract trauma
TISSUE – retained placental tissue
THROMBIN – coagulopathies
 
 
Treatment Options:
  • Empty the uterus: deliver fetus/placenta/retained products
  • Oxytocin / ergometrine / prostaglandin
  • Massage & bimanual compression of uterus
  • Repair genital tract injury
  • Uterine packing, blakemore or Rusch balloon
  • Compression of aorta
  • Surgical or IR: internal iliac or uterine artery ligation, hysterectomy, arterial embolisation
 
 
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