Fluid Management of Maternal Hemorrhage Dr.Hantoushzadeh.

Slides:

Advertisements

Similar presentations

Anesthetic Management of The Trauma Patient. Baseline Prior To OR BP 90/40 | HR 130s | Intubated CV Left chest ant & post wounds/ left calf wound Right.

Advertisements

Transfusion in Cardiopulmonary Bypass. Blood Use & Cardiac Surgery 1971 – average 8 units RBC per case Late 1980’s – Texas Heart Institute 1.4 units per.

Nahida Chakhtoura, M.D..  Postpartum hemorrhage (PPH): leading cause of maternal mortality worldwide  Prevalence rate: 6%  Africa has highest prevalence.

Obstetric Hemorrhage Abike James MD Assistant Clinical Prof. Obstetrics and Gynecology University of Pennsylvania.

Postpartum Hemorrhage(PPH) 产后出血林建华. Major causes of death for pregnancy women （ maternal mortality) Postpartum hemorrhage （ 28%) heart diseases pregnancy-induced.

Postpartum Hemorrhage Christopher R. Graber, MD Salina Women’s Clinic 21 Feb 2012.

Postpartum Hemorrhage (PPH) and abnormalities of the Third Stage Sept 12 – Dr. Z. Malewski.

Hemorrhagic diseases. Lesions of the blood vessels Lesions of the blood vessels Abnormal platelets Abnormal platelets Abnormalities in the coagulation.

Postpatrum Hemorrhage and Third Stage Emergencies

Brad Beckham T4. Definitions  Major blood loss Hemoglobin concentration below 6-10 g/dl  Massive transfusion in adults >9 erythrocyte units within 24h.

Massive transfusion: New Protocol

Haematology. Help I need blood! Both O negative and group specific are unsuitable for patients with antibodies…

By Dr. Ahmed Mostafa Assist. Prof. of anesthesia & I.C.U.

Leanna R. Miller, RN, MN, CCRN-CSC, PCCN-CMC, CNRN, CEN, NP Education Specialist LRM Consulting Nashville, TN.

Massive Transfusion Mary Jo Drew, MD, MHSA Chief Medical Officer Pacific Northwest Blood Services Region.

Cristy M. Thomas FNP-BC University of Nevada School of Medicine University Medical Center, Las Vegas NV Nevada’s Only Level 1 Adult Trauma, Level 2 Pediatric.

D - DEATH I - IS C - COMING DIC is an important contributor to maternal mortality and morbidity.

Definition of Massive Transfusion Replacement of a blood volume equivalent within 24hr Transfusion>10 unit within 24 hr Transfusion > 4 units in 1 hr.

Blood component therapy

Obstetric Hemorrhage Anne McConville, MD

Placental Abruption Liu Wei Department of Ob & Gy Ren Ji hospital.

Postpartum Haemorrhage. Definitions Primary PPH – blood loss of 500ml or more within 24hours of delivery. Secondary PPH – significant blood loss between.

Post Partum Hemorrhage

4th year medical students Blood Component Therapy Salwa I Hindawi MSc FRCPath CTM Director of Blood Transfusion Services KAUH. Jeddah.

ANTEPARTUM HAEMORRHAGE. Obstetric Haemorrhage  Ranks as the First cause of maternal mortality accounting for 25 – 50 % of maternal deaths.

Amniotic Fluid Embolism Women ’ s Hospital School of Medicine Zhejiang University Wang Zhengping.

Maternal Mortality and Hemorrhage Gina M. Brown, MD NYC Department of Health and Mental Hygiene Bureau of Maternal, Infant and Reproductive Health.

Operational Obstetrics & Gynecology · Bureau of Medicine and Surgery · 2000 Slide 1 Abnormal Pregnancy CAPT Mike Hughey, MC, USNR.

Maternal Mortality - Obstetrical Hemorrhage - Dr. Adiel Fleischer

Critical Care in Life Threatning Obstetrics Emergencies – Can Save Mother and Child Dr. Sharda Jain Chairman, Dept of O/G - Pushpanjali Crosslay Hospital.

Dr Ahmed abdulwahab. Hemorrhage is still one of the leading cause of maternal mortality all over the world DEFINITION Primary post partum hemorrhage.

Post Partum Hemorrhage Akmal Abbasi, M.D.. Post Partum Hemorrhage  Obstetric Haemorrhage:Ranks as the First cause of maternal mortality accounting for.

Antepartum Haemorrhage and Postpartum Haemorrhage

Sepsis and Early Goal Directed Therapy

1 Todays Objectives  Compare and contrast pathophysiology & manifestations of the various shock states and the physiologic compensatory mechanisms. 

Postpartum Hemorrhage

Whole Blood After transfusion with one unit of whole blood, 1.0g/dL hemoglobin indications for transfusion with whole blood are hemorrhagic shock with.

MASSIVE TRANSFUSION OB ROUNDS, JAN RECOMMENDATIONS FOR MASSIVE TRANSFUSION Assuming: Previously healthy 70 kg adult No cardiac disease Not anaemic.

Postpartum Complications Perinatal Practicum. Common postpartum complications Postpartum hemorrhage Hypertensive disorders Infection Venous disorders.

Hemorraghic Shock Sara Parker MD VCU Trauma Conference STICU Fellow

Copyright 2008 Society of Critical Care Medicine

Intern 謝旻翰. Introduction (I) Benefit –Volume restoration, improved O2 carrying capacity Risk –Transfusion reaction, blood-bore pathogen, limited supply,

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.

ASSOCIATE PROFESSOR IOLANDA BLIDARU MD, PhD.

DR G SIYAKA Obstetric anaesthesia OUTLINE Physiological changes of pregnancy Anaesthesia for caesarean delivery Analgesia for labour Complications.

Early goal directed therapy in the treatment of sepsis Nouf Y.Akeel General surgery demonstrator Saudi board trainee R3.

Antepartum Hemorrhage Family Medicine Specialist CME University of Health Sciences.

In the name of GOD. POSTPARTUM HEMORRHAGE Dr. Farahnaz Keshavarzi Ob. & Gyn. Department Kermanshah University of Medical Sciences.

Postpartum Hemorrhage

PRINCIPLES OF FLUIDS AND ELECTROLYTES

Shock and its treatment Jozsef Stankovics Department of Paediatrics, Medical University of Pécs 2008.

Postoperative Challenges in Neurocritical Care SNACC and NCS Joint Presentation Andrea Orfanakis, MD Oregon Health and Science University Multi-Level Spinal.

BLOOD TRANSFUSION Ferdi Menda,M.D. Assistant Prof of Anesthesiology Yeditepe University.

Blood and Blood Products. Whole Blood n Contents –RBC’s –WBC’s –Platelets –Plasma –Clotting factors.

Chapter 33 Postpartum Complications Mosby items and derived items © 2012, 2007, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.

Management of Antepartum Fetal Death

Hypovolemic Shock General Surgery Orientation Medical Student Lecture Series Juan Duchesne MD, FACS, FCCP, FCCM Associate Professor of Trauma/Critical.

Obstetrical emergencies

Multiple choice questions

POSTPARTUM HEMORRHAGE

Management Based Criteria

Postpartum Hemorrhage

Amniotic Fluid Embolism

Postpartom hemorrhage

IN THE NAME OF GOD.

Maternal Mortality and Hemorrhage

Post Partum Hemorrhage

Presentation transcript:

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 % Incr. HR, orthostasis, mental Decr cap refill Crystalloid, III % 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 blood ccHct %1u =1g/dl Hb PRBC ccHct %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