Postpartum haemorrhage-nightmare to expertise

6^th World Congress on Womens Health and Midwifery

July 11, 2022 | Webinar

Shashi L Kabra Maheshwari

Senior specialist (OBG) and NBE teacher | India

ScientificTracks Abstracts: J Nurs Res Pract

Abstract :

Postpartum haemorrhage is a maternal complication of concern. It accounts for nearly a quarter of maternal deaths worldwide. PPH – Defined as • Estimated blood loss of ≥ 500 mL after vaginal delivery or • Estimated blood loss of ≥ 1000 mL after caesarean section or • A Reduction in the patient's haematocrit level of > 10% compared with prenatal value or Blood loss causing hemodynamic instability of sufficient degree to require blood transfusion. Causes of PPH: • Tone – Atonic uterus (70%) • Trauma- Lacerations, hematomas, inversion, rupture (20%) • Tissue- retained tissue, invasive placenta (10%) • Thrombin- coagulopathy (1%) Prevention of PPH? AMTSL (WHO) • Oxytocin (10 IU, IV/IM) is the recommended uterotonic drug for the prevention of PPH, within one minute of delivery. Medical Management of PPH Uterotonics: • Oxytocin Drug of choice • Methergine • 15 Methyl Prostaglandin F 2 alpha • Misoprostol • Tranexamic acid Surgical management of PPH • Uterine balloon tamponade • Brace sutures • Stepwise devascularisation • Hysterectomy We should use all modalities of PPH bundle within 2 hrs for the management of such patient. Recent Publications: Maheshwari, Shashi & Kumari, Nisha & Ahmad, Syed Nawaz. (2018). Role of bilateral internal iliac artery ligation in severe obstetric and gynaecological hemorrhage. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 7. 1090. 10.18203/2320-1770.ijrcog20180898.

Biography :

Shashi L Kabra Maheshwari is a senior specialist for Obstetrics and also a National Board Of Examinations (NBE) teacher. She has earned many outstanding awards in the field of Gynecology and Obstetrics; some are IMA appreciation award, Recipient of wonder FOGSI award, APJ Abdul Kalam appreciation award, IMA WDW Karamveer award, Rashtriya Gaurav award, and Asia GCC award quality leader health. She has chaired many events like Association of Obstetricians & Gynaecologists of Delhi (AOGD) 20-22. She is also a national coordinator of LAQSHYA project which is in association with AIIMS Delhi GOI WHO. She is the President of Delhi Gynecologist Forum South West (DGF SW) and member of practical obstetric committee Federation of Obstetric and Gynecological Societies of India. Her areas of interests are high risk pregnancy, emergency Obstetrics, and Obstetrics Hemorrhage. She has organized more than 50 workshops on Postpartum hemorrhage (PPH).