Download Free Medical Obstetric Emergencies - Postpartum Hemorrhage and Hypertension PowerPoint Presentation

Obstetric Emergencies - Postpartum Hemorrhage and Hypertension PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Obstetrics & Gynecology, which is titled "Obstetric Emergencies - Postpartum Hemorrhage and Hypertension", to know about Postpartum Hemorrhage and Hypertension.

Tags : Obstetrics, Gynecology, Obstetric Emergencies, Postpartum Hemorrhage, Hypertension

Published on : Jul 18, 2021 | Views : 2098 | Downloads : 7

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Obstetric Emergencies Postpartum Hemorrhage and Hypertension Annelee Boyle, MD, FACOG Assistant Professor Department of Obstetrics and Gynecology Division of Maternal-Fetal Medicine University of Virginia School of Medicine
Slide 2-

ppt slide no 2 content not found
Slide 3-

ppt slide no 3 content not found
Slide 4-

Disclosures
Slide 5-

Pregnancy-related mortality in the United States: 1987-2010 Source: CDC Pregnancy Mortality Surveillance System
Slide 6-

Obstetrics and Gynecology, May 2014
Slide 7-

Causes of pregnancy-related death in the United States: 2006 -2010 Source: CDC Pregnancy Mortality Surveillance System
Slide 8-

Maternal mortality is only the tip of the iceberg
Slide 9-

Obstetrics and Gynecology, February 2012
Slide 10-

93% of deaths preventable! Berg et al. Preventability of pregnancy related deaths: results of a statewide review. Obstet Gynecol 2005; 106:1228-34. Common mistakes: Under-recognition of blood loss Under-recognition of hypovolemia Failure to act decisively Failure to restore blood volume Postpartum Hemorrhage
Slide 11-

Recognize the extent of blood loss Dildy et al, Estimating Blood Loss: Can Teaching Significantly Improve Visual Estimation? Obstetrics & Gynecology. 104(3):601-606, September 2004.
Slide 12-

Recognize the extent of hypovolemia
Slide 13-

Obstetrics and Gynecology, May 2014
Slide 14-

Systolic BP <90 or >160 Diastolic BP >100 Heart Rate <50 or >120 Resp Rate <10 or >30 Oxygen Sat <95% on room air Urine output <35ml/hr for 2 hours Agitation, confusion, or unresponsiveness Shortness of breath or a non-remitting headache in a patient with pre-eclampsia Mhyre et al. The maternal early warning criteria: a proposal from the national partnership for maternal safety. Obstet Gynecol 2014;124:782-6. Early warning signs
Slide 15-

Act decisively/Restore blood volume
Slide 16-

Rule number one: Postpartum Hemorrhage is a definition, not a diagnosis! Post-Partum Hemorrhage
Slide 17-

Actively manage the third stage of labor Pearls for Atony
Slide 18-

Consider additional utero-tonics for those at highest risk of PPH Pearls for Atony
Slide 19-

Have a low threshold for going to the OR for repair. Pearls for Lacerations
Slide 20-

ppt slide no 20 content not found
Slide 21-

Source: California Maternal Quality Care Collaborative
Slide 22-

60% of deaths are preventable! Berg et al. Preventability of pregnancy related deaths: results of a statewide review. Obstet Gynecol 2005; 106:1228-34. Common mistakes: Failure to adequately control blood pressure Failure to recognize HELLP syndrome Failure to diagnose and treat pulmonary edema Preelcampsia
Slide 23-

Systolic BP <90 or >160 Diastolic BP >100 Heart Rate <50 or >120 Resp Rate <10 or >30 Oxygen Sat <95% on room air Urine output <35ml/hr for 2 hours Agitation, confusion, or unresponsiveness Shortness of breath or a non-remitting headache in a patient with pre-eclampsia Mhyre et al. The maternal early warning criteria: a proposal from the national partnership for maternal safety. Obstet Gynecol 2014;124:782-6. Early warning signs
Slide 24-

Control Blood Pressure
Slide 25-

Control Blood Pressure
Slide 26-

Hi Annelee. Hope you’re doing well and liking your new job. It’s 10:30 pm here and for me, that’s the middle of the night so rather than be friendly and “chat”, I’m going to get straight to the point – it’s business… So our hospital protocol essentially regurgitates ACOG, but it doesn’t specify that it is for use only with preeclamptic/eclampic patients. Would you use it for someone with chronic HTN also, barring known renal disease or other cause of the HTN? Thanks! Love, Aunt Crunchy
Slide 27-

Recognize HELLP Syndrome
Slide 28-

The most important paper on HTN in pregnancy in the last year
Slide 29-

SBP >160 DBP >110 Platelets < 100,000) LFTs >2x normal Creatinine > 1.1 Pulmonary edema New-onset cerebral or visual disturbances Right upper quadrant pain American College of Obstetricians and Gynecologists. Hypertension in pregnancy: executive summary. Obstet Gynecol 2013;122:1122–31. Severe Features of Preeclampsia
Slide 30-

Recognize and treat pulmonary edema
Slide 31-

ppt slide no 31 content not found
Slide 32-

“If you’re going down take everybody else with you.” Susan Modesitt, Gyn Oncologist The UVA way (or maybe it was UNC)
Slide 33-

David Barker 1938-2013
Slide 34-

The Barker Hypothesis The Thrifty Phenotype Fetal Origins Hypothesis
Slide 35-

Intrauterine Growth Restriction
Slide 36-

30 years from now
Slide 37-

Thank you!!!