DIRECTION: Read related literature on postpartum hemorrhage.
Provide answer to the
following questions. (Please indicate your references at the end of your output.)
1. What is the role of a complete blood count (CBC), blood urea nitrogen (BUN)/ creatinine
measurement in the diagnosis of postpartum hemorrhage (PPH)?
- Complete Blood Count or CBC is performed to alert if the pregnant women are experiencing
anemia and will indicate what interventions will be done in order to improve the hemoglobin
level. CBC is helpful in diagnosing postpartum hemorrhage, the hemoglobin and hematocrit are
helpful to estimate blood loss during delivery and if blood transfusions are needed and also if
the white blood cell count is elevated, suspect endometriotis or toxic shock syndrome. While
blood urea nitrogen (BUN)/ creatinine measurement can be helpful in identifying renal failure as
a complication of shock. If the BUN level rises during or after resuscitation with blood products,
consider red blood cell hemolysis as a complication.
2. What is the role of coagulation studies in the diagnosis of postpartum hemorrhage
(PPH)?
- Elevations of the prothrombin time (PT), activated partial thromboplastin time (aPTT), and
international normalized ratio (INR) can indicate a present or developing coagulopathy.
3. Why is blood type and cross-match performed in the workup of postpartum hemorrhage
(PPH)?
- Blood type and cross-match is performed to begin the process of finding appropriately matched
blood for resuscitation in the event that it is needed.
4. What is the role of liver function tests (LFTs) in the diagnosis of postpartum hemorrhage
(PPH)?
- These studies can be helpful in considering other abdominal pathology, such as HELLP
syndrome, if there is abdominal pain in addition to, or instead of, uterine tenderness.
5. What is the role of medications in the treatment of postpartum hemorrhage (PPH)?
- Since postpartum hemorrhage is one of the risk factor, active management is needed the use of
medication is effective and important for example Use of oxytocin after delivery of the anterior
shoulder is the most important and effective component of this practice. Oxytocin is more
effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse
effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal
laceration. Appropriate management of postpartum hemorrhage requires prompt diagnosis and
treatment.