NURS 323 Lecture Notes - Lecture 25: Episiotomy, Amnion, Hematoma
25 Feb 2021
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*very common to encounter pph in the er. Thrombin: coagulopathy occurs within 24 hours after birth fundle massage. Iv oxytocin and other uterotonics bleeding post uterotonic administration: applying pressure, surgical removal of placenta, bakery balloon (packing in uterus, collects 500ml of blood) occurs from 24 hours to 12 weeks after delivery (most commonly 1-2 weeks after delivery) Hematoma collection of blood in the body outside of a blood vessel. Puerperal hematomas: found in the vulva or retroperitoneal space and are often a result of brith (episiotomies, lacerations) Management: foley catheter (can impede urination) risk factors: first birth, preeclampsia, prolonged first/second stage of labour, vulvar varicosities, multifetal pregnancy, fetal macrosomia, maternal obesity and clotting disorders. Hypovolemic shock can be caused by uncontrolled hemorrhage blood flow needs to be rerouted to the brain and heart. Management: crystalloid fluids (normal saline, lactated ringers) Uti febrile complications: can result from being under anesthetic clostridium difficile management: 14 day vancomycin.
