K. 1 in 200
Each of the following Options describes various Percentages on woman presenting with postpartum haemorrhage. For each patient select the single most appropriate Percentage from the list above. Each option may be used once, more than once or not at all
1. 26 year old Tesisly has delivered 6weeks back . She underwent cesarean section for prolonged rupture of membranes with suspected chorioamnionitis. Now she has presented with heavy vaginal bleeding . Her ultrasound shows retained membranes -she is for evacuation of uterus. What is her chances of having uterine perforation?
2. Sherlye, 32 year old ,primiparous and a normal vaginal delivery. With removal of placenta she has increased vaginal bleeding. Her quantified blood loss is 1700ml. She was managed with balloon tamponade. In what percentage of women, hysterectomy is avoided withtamponade?
3. What percentage of women with massive PPH needs to be notified to the risk management team?
4. Sherlye, 32 year old, primiparous and a normal vaginal delivery. With removal of placenta she has increased vaginal bleeding. Her quantified blood loss is 1800ml. Bleeding wasn’t controlled with oxytocin’s, balloon tamponade. She was shifted to Operation theatre for B lynch suture & bleeding controlled with that. In what percentage of woman, hysterectomy is avoided with B lynch suture?
5. Active management of third stage of Labour decreases PPH by ——-percentage
A. Oxytocin 5units Iv
B. Oxytocin 10unitsIM
E. Carborpost -4th dose to be given
G. Consider Shifting to OT
I. Stepwise devascularisation
K. Tranexmic acid 1gm IV
Each of the following Options describes various management of woman with postpartum haemorrhage. For each patient select the single most appropriate management from the list above. Each option may be used once, more than once or not at all.
6. 34 year old Rebecca , into her second pregnancy , a low risk pregnancy . Which is best drug to prevent atonic PPH?
7. 30 year old Leslie is undergoing elective cesarean section for breech presentation, what is the best drug for prophalyxis of PPH
8. 34 year old Rachel in her third pregnancy, low risk pregnancy. She is fully dilated and pushing, she has a history of atonic PPH in her previous delivery, what is the appropriate prophylactic drug for her?
9. 36year old Lisa is undergoing elective cesarean section for Twin pregnancy with transverse lie of first baby along with oxytocin which other dug can be considered to reduce risk of PPH?
10. Sherlye, 32 year old, primiparous and a normal vaginal delivery. With removal of placenta she has increased vaginal bleeding. Quantified blood loss is 1000ml. She has been started with all resuscitation measures with blood transfusion. She has received oxytocin, ergometrine, 3 doses of carboprost given 15minutes apart. She is continuing to bleed. What is next best step?