We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byLea Tronson
Modified over 2 years ago
Fluid Management of Maternal Hemorrhage Dr.Hantoushzadeh
2 Maternal Mortality -All pregnancies- EtiologyM. Hemorrhage28.7% Embolism19.7% P.I.H.17.6% Infection13.1% Cardiomyopathy5.6% Anesthesia complic2.5% Others12.7%
3 1- Identify risk - Placenta previa/accreta -Anticoagulation Rx -Coagulopathy -Over distended uterus -Grand multiparity -Abnormal labor pattern -Chorioamnionitis -Large myomas -Previous history of PPH Maternal Mortality - Obstetrical Hemorrhage -
4 O 2 Delivery = C.O. x Sa O 2 x Hb% Fluid management Oxygenation Transfusion Maintain aerobic metabolism Hemorrhagic Shock - Management - CO = cardiac output SaO2 = Systemic arterial oxygen saturation
5 ClassBlood Loss Volume Deficit SpxRx I < 1000 cc15% Orthostatic tachycardia Crystalloid II 1001-150015-25% Incr. HR, orthostasis, mental Decr cap refill Crystalloid, III 1501-250025-40% Incr HR, RR Decr BP, Oliguria Crystalloid Colloid, RBCs IV > 2500 > 40% Obtunded Oliguria/anuria CV collapse RBC, Crystalloid, Colloid Managing blood loss by hemorrhage classification
6 Blood Components ProductVolumeComponents Indication/ Utility Whole blood450-500 ccHct. 36-44%1u =1g/dl Hb PRBC200-250 ccHct. 70-80%1u = 1g/dl Hb Platelets30-50ccPlatelets WBC Ag1u = 5000uL FFP100cc Fibrinogen, clotting factors PT, PTT> 1.5 x nl, INR > 1.6 Cryo- precipitate 50-75cc Factor 8c, Von Willebrand’s factor, Fibrinogen Fibrinogen replacement
Factor Replacement Therapy VWF Hemophilia Acquired Inhibitors Plasmapheresis
Platlets transfusion ITP Acute Fatty Liver HELP Sever Preeclampsia IUFD Placental Abruption
Maternal Mortality and Hemorrhage Gina M. Brown, MD NYC Department of Health and Mental Hygiene Bureau of Maternal, Infant and Reproductive Health.
Dr Ahmed abdulwahab. Hemorrhage is still one of the leading cause of maternal mortality all over the world DEFINITION Primary post partum hemorrhage.
Brad Beckham T4. Definitions Major blood loss Hemoglobin concentration below 6-10 g/dl Massive transfusion in adults >9 erythrocyte units within 24h.
ASSOCIATE PROFESSOR IOLANDA BLIDARU MD, PhD.
Massive Transfusion in Trama By R1 彭育仁. Brief History(1) 26 y/o male came to our ER due to massive bleeding from cutting wound over right neck and left.
Obstetric Hemorrhage Anne McConville, MD
Nahida Chakhtoura, M.D.. Postpartum hemorrhage (PPH): leading cause of maternal mortality worldwide Prevalence rate: 6% Africa has highest prevalence.
Postpatrum Hemorrhage and Third Stage Emergencies
Critical Care in Life Threatning Obstetrics Emergencies – Can Save Mother and Child Dr. Sharda Jain Chairman, Dept of O/G - Pushpanjali Crosslay Hospital.
Hemorraghic Shock Sara Parker MD VCU Trauma Conference STICU Fellow
Massive transfusion: New Protocol
MASSIVE TRANSFUSION OB ROUNDS, JAN RECOMMENDATIONS FOR MASSIVE TRANSFUSION Assuming: Previously healthy 70 kg adult No cardiac disease Not anaemic.
Maternal Mortality - Obstetrical Hemorrhage - Dr. Adiel Fleischer
Definition of Massive Transfusion Replacement of a blood volume equivalent within 24hr Transfusion>10 unit within 24 hr Transfusion > 4 units in 1 hr.
Postpartum Hemorrhage Christopher R. Graber, MD Salina Women’s Clinic 21 Feb 2012.
Chapter 33 Postpartum Complications Mosby items and derived items © 2012, 2007, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
By Dr. Ahmed Mostafa Assist. Prof. of anesthesia & I.C.U.
D - DEATH I - IS C - COMING DIC is an important contributor to maternal mortality and morbidity.
© 2017 SlidePlayer.com Inc. All rights reserved.