It just won't stop!

 

This SAQ is worth 18 marks

A 25 year old woman has been rushed in to your resuscitation room. She has just delivered a baby in the passenger seat of a car being driven by her husband. The baby was 38 weeks gestation and appears to be well. The placenta was delivered in the car.

The woman is experiencing heavy vaginal blood loss.

Question 1.
In the table below, list 6 possible causes of her vaginal bleeding.

For each cause give:
- one cardinal finding of examination that would support that cause
- one cardinal principle of management of that cause (18 marks)

Cause Examination  Management

 

 

 

 

   

 

 

 

 

   

 

 

 

 

   

 

 

 

 

   

 

 

 

 

   

 

 

 

 

   



 

This SAQ is worth 18 marks

A 25 year old woman has been rushed in to your resuscitation room. She has just delivered a baby in the passenger seat of a car being driven by her husband. The baby was 38 weeks gestation and appears to be well. The placenta was delivered in the car.

The woman is experiencing heavy vaginal blood loss.

Question 1.
In the table below, list 6 possible causes of her vaginal bleeding.

For each cause give:
- one cardinal finding of examination that would support that cause
- one cardinal principle of management of that cause (18 marks)

Cause Examination  Management

Retained products of conception / placenta

  • incomplete placenta
  • non-contracted uterus 
  • OT for manual removal
  • oxytocin

uterine atony

  • non-contracted uterus
  • uterine massage
  • oxytocin
  • empty bladder

 trauma – vaginal/cervical laceration

  • direct inspection / speculum examination shows laceration 
  • surgical correction
uterine rupture

 

  •  severe abdominal tenderness
  • surgical correction in OT 

 uterine inversion

  • visual inspection of perineum shows inverted uterus
  • fundus too low
  • uterine re-location - OT 
coagulopathy

 

  • no other cause obvious
  • blood not clotting
  • correct coagulopathy with blood products 

 

PASS 12/18 corrects to 6.5/10 




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post-partum   haemorrhage   PPH