| ID | 342 |
|---|---|
| Name | ACCIDENTAL HEMORRHAGE |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | Management: A. Revealed accidental hemorrhage- 1. Bed rest- if bleedeng is slight. 2. Cases with more severe bleeding- a. Hospitalization. b. Bed rest, blood transfusion, sedation, monito-ring of maternal pulse, B.P, fundal height, foetal heart sound, c. When bleeding stops try to find out the cause of APH by specular examination and best if ultrasonogram facility exists, d. Keep the pt. upto 38 weeks. After 38 weeks- under G/A with all prepa-ration for C/S, p/v done to find placenta-previa if or not. 11 If placenta previa absent- e. Low rupture of membrane under anesthesia. f. Oxytocin drip may be given, if delay. g. 2nd stage should be shortened. h. Intravenous inj. of Ergometrine 0.5mg after the birth of head. B. Concealed accidental hemorrhage- 1. Treatment of shock by- a. Morphine 15mg. b. Blood transfusion. 2. After initial treatment of shock the membrane should be ruptured, and syntocinon drip. 3. Cesarean section may also be needed. 4. If hypofibrinogenemia develops- give 2-1 Ogm of fibrinogen in solution. 5. Bleeding + uterine atony -C/S + hysterectomy. |
| Introduction | |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | |
| Complications | |
| Prognosis | |
| Types | Two types of accidental hemorrhage- A. Revealed accidental hemorrhage- with or without any obvious existing cause the patient notices blood coming from the vagina. There may be slight abdominal discomfort and tenderness over the placenta! site. On P/V exam.- friable smooth blood clot may fill the vagina and cervix, but the placenta cannot be felt. B. Concealed accidental hemorrhage- patient complains of sudden attack of abdominal pain, she looks ill & pale, her pulse rate raised, uterus distended and is larger than the period of gestation, wooden hard in consistency & extremely tender; foetal heart sound is absent & foetal parts are difficult to make out. In severe case patient may come in a state of shock. |
| Classification | |
| Observation | |
| Pathology |
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