(O67) Labour and delivery complicated by intrapartum haemorrhage, not elsewhere classified

Intrapartum haemorrhage, not elsewhere classified, is a type of labour and delivery complication where a woman experiences excessive bleeding during the delivery process. it can be caused by a variety of factors, including placenta previa, placental abruption, uterine rupture, and umbilical cord complications. it is a serious medical condition and can lead to significant blood loss and even death if not treated promptly.

Intrapartum haemorrhage is a common complication of labour and delivery, and can be caused by a variety of underlying factors. these factors can include uterine rupture, placental abruption, placental previa, or trauma to the birth canal. additionally, certain medical conditions such as hypertension, diabetes, or clotting disorders can increase the risk of intrapartum haemorrhage. as a result of these conditions, the uterus can be weakened, leading to a greater risk of bleeding during labour and delivery.

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• Obtain a detailed history of the patient’s pregnancy and delivery.
• Conduct a physical examination of the patient.
• Order laboratory tests to assess the patient’s blood clotting function.
• Perform an ultrasound to assess the patient’s uterus for any abnormalities.
• Evaluate the patient’s vital signs and blood pressure.
• Conduct an endovaginal ultrasound to assess the placenta.
• Order a CT scan to evaluate for any uterine abnormalities.
• Perform a biopsy of the placenta to assess for any bleeding abnormalities.
• Order a complete blood count to assess the patient’s level of hemoglobin.
• Perform a pelvic examination to assess for any signs of infection.
• Collect a urine sample to assess for any signs of infection.

Additional measures:

• Perform a laparoscopy to assess for any abnormalities in the uterus.
• Order a transvaginal ultrasound to assess for any abnormalities in the uterus.
• Order an MRI to evaluate for any uterine abnormalities.
• Evaluate the patient for any signs of shock.

Main goal of the treatment: To reduce the risk of maternal mortality and morbidity associated with intrapartum haemorrhage.

• Monitor maternal vital signs and haemodynamic status.
• Administer appropriate intravenous fluids and blood products.
• Administer uterotonic medications to reduce blood loss.
• Assess the need for surgical intervention.
• Provide appropriate analgesia.
• Monitor the fetal heart rate.
• Manage any associated complications.
• Provide appropriate follow-up care for the mother.

To prevent intrapartum haemorrhage, pregnant women should receive regular antenatal care throughout their pregnancies, including monitoring of the baby's growth and fetal wellbeing, and appropriate management of any risk factors. additionally, women should be encouraged to deliver in a medical facility with trained personnel available to provide assistance if necessary.