Presentation is loading. Please wait.

Presentation is loading. Please wait.

H. Gee MD, FRCOG Consultant Obstetrician

Similar presentations


Presentation on theme: "H. Gee MD, FRCOG Consultant Obstetrician"— Presentation transcript:

1 H. Gee MD, FRCOG Consultant Obstetrician

2 Aims Reduce complication rate at c-section Infection Haemorrhage
Damage to other organs

3 Post operative sepsis Where Prevent Wound Uterus Hand washing
Bladder Prevent Hand washing Patient washing Reduce VE Sterile instruments Prophylactic antibiotics

4 How to Reduce Sepsis Critical incident review Audit
Evidence - Standards Detect where can improve Institute improvement Re-audit

5 Bladder Injury Heavy Haematuria
Leave catheter in for 10 days if blood stained ? Antibiotics

6 Haemorrhage Good haemostasis C-section at right time
Avoid Prolonged Labour Avoid Obstructed Labour Clotting abnormalities in abruption

7 Obstructed labour Impacted head – Thin lower segment – tears –
Disimpact before start Midwife push up from below Thin lower segment – tears – Release pressure slowly High incision top lower segment Lift uterus out of abdomen to see tears before suturing

8 Communication with anaesthetist
Warn anaesthetist oxytocin/ergometrine/misoprotol ready Tell anaesthetist immediately excessive bleeding starts Increase fluids Get blood transfusion

9 How to reduce Haemorrhage
Critical incident review/Reflective practise- If got to hospital just in time Very thin lower segment – thank midwife ambulance driver WHY BABY/MOTHER DIED NO TRAINING – did not fill in partogram NO EQUIPMENT – no transport MATERNAL HEALTH VERY POOR

10 Audit Audit Standards Identify factors Institute change Re-audit

11 Who needs Subtotal hysterectomy?
Placenta accreta Ruptured uterus & cannot repair Placenta praevia severe bleeding from lower segment Atonic uterus not responding to treatment

12 B- LYNCH SUTURE


Download ppt "H. Gee MD, FRCOG Consultant Obstetrician"

Similar presentations


Ads by Google