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Seminar On Postpartum Haemorrhage, Retained Placenta, Placenta Accreta and Role of Nurse in Critical Care in Obstetrics

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SEMINAR ON

POSTPARTUM
HAEMORRHAGE,
RETAINED PLACENTA,
PLACENTA ACCRETA AND
ROLE OF NURSE IN
CRITICAL CARE IN
OBSTETRICS

POSTPARTUM
HAEMORRHAGE
Definition

Any amount of bleeding from or into the


genital tract following birth of the baby up to
the end of the puerperium which adversely
affects the general condition of the patient
evidenced by rise in pulse rate and falling
blood pressure is called postpartum
haemorrahage.

Types
Primary
- Third stage haemorrhage
- True post partum haemorrhage
Secondary

Causes
Atonic uterus
Traumatic
Retained tissues
Blood coagulopathy

Complications
Haemorrhage due to incomplete removal
Shock
Injury to the uterus
Infection
Inversion
Subinvolution
Thrombophlebitis
Embolism

SECONDARY PPH
Causes
Retained bits of cotyledon or membrane
Infection and separation of slough over a

deep cervico- vaginal laceration


Endometritis and subinvolution of the
placental site
Estrogen therapy

Retained placenta
Definition
The placenta is said to be retained when it is

not expelled out even 30 minutes after the


birth of the body.

Dangers
Haemorrahge
Shock
Puerperial sepsis
Risk of its occurance in next pregnancy

Placenta accreta
It is an extremely rare form in which the

placenta is directly to anchored to the


myometrium partially or completely without
any intervening decidua.

Risk factors
Placenta previa
Prior caesarean delivery
Prior uterine surgery
Increasing maternal age
Parity

Risks
Haemorrhage
Shock
Inversion of uterus

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