Learning Outcomes

When you have studied this session, you should be able to:

• Define and use correctly all of the key words printed in bold.
• Describe methods of prevention of obstetric hemorrhage
• Identify signs of impending maternal collapse with a normal blood pressure
• Describe sign of life-threatening hypovolaemia.
• Discuss the steps in initial resuscitation and stabilization of obstetric hemorrhage
• Describe the 4Ts: Directed therapy and definitive treatment ofobstetric hemorrhage
• Identify drugs used in obstetric hemorrhage
• Describe the techniques of blood transfusion for obstetric hemorrhage
• List specialist techniques used in the management of obstetric hemorrhage
• Describe anaesthesia techniques used in obstetric hemorrhage

Key points

• Major Heamorrhage is defined as a single blood loss of > 1500 ml, continuing blood loss of 150 ml/hr or a transfusion requirement of 4 units of red cells.
• The early team approach to managing major hemorrhage will improve the outcome for the mother
• Early resuscitation is essential
• Early diagnosis of the cause of major haemorrhage will focus therapy and can be easily remembered by thinking of the 4Ts
• Specialist techniques of balloon tamponade or B-Lynch suture are effective in persistent uterine atony
• Coagulation failure occurs early in obstetric haemorrhage and should be corrected if possible
• After care of the mother with regular monitoring of heart rate, blood pressure, urine output will improve outcome.