Midterm

• Postpartum hemorrhage is defined as excessive bleeding after childbirth, with risk factors including uterine atony, lacerations, retained placental fragments, uterine inversion, and disseminated intravascular coagulation

  
• The four T's of postpartum hemorrhage are: tone, tissue, trauma, and thrombin

  
• Uterine atony is when the uterus is unable to contract after childbirth, leading to postpartum hemorrhage
• Retained products of conception, trauma during childbirth, and disseminated intravascular coagulation can also lead to postpartum hemorrhage
• Uterine atony is the most common cause of postpartum hemorrhage, where the uterus relaxes after childbirth and does not contract properly, leading to bleeding from the veins

  
• Therapeutic management of postpartum hemorrhage includes uterine massage, observation of the fundus, intravenous infusion of oxytocin, and the use of medications like IM Carboprost tromethamine (Hemabate) or methylergonovine maleate (Methergine)

  
• Rectal misoprostol, a prostaglandin E1 analogue, may also be administered rectally for postpartum hemorrhage
• Conditions that increase a woman's risk for postpartum hemorrhage include those that distend the uterus beyond average capacity, could cause cervical or uterine lacerations, and have varied placental site or attachment

  
• Management options for postpartum hemorrhage include medications, blood replacement, and surgery

  
• Management options for postpartum hemorrhage include medications, uterine massage, and blood replacement