Medicine an Surgery notes

Apr 24th, 2015
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POSTPARTUM HEMORRHAGEDefinitionPPH is defined as blood loss of more than 500 mL following vaginal delivery or more than 1000 mL following cesarean delivery PPH should be diagnosed with any amount of blood loss that threatens the hemodynamic stability of the woman.Hemorrhage may occur before, during, or after delivery of the placenta.The diagnosis of PPH is usually reserved for pregnancies that have progressed beyond 20 weeks' gestation.ClassificationA loss of these amounts within 24 hours of delivery is termed early or primary PPH, whereas such losses are termed late or secondary PPH if they occur between 24 hours and 6 weeks after deliveryEpidemiology:Postpartum hemorrhage (PPH) is the leading cause of maternal mortalityWorld Health Organization statistics suggest that 25% of maternal deaths are due to PPH The incidence of excessive blood loss following vaginal delivery is 5-8%. Postpartum hemorrhage is the most common cause of excessive blood loss in pregnancy, and most transfusions in pregnant women are performed to replace blood lost after delivery. In less-developed countries, hemorrhage is among the leading obstetric causes of maternal death.The frequency of PPH is related to the management of the third stage of labor.Data from several sources, including several large randomized trials performed in industrialized countries, indicate that the prevalence rate of PPH of more than 500 mL is approximately 5% when active management is used versus 13% when

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