NUR1 233 Lecture Notes - Arteriole, Leukocytosis, Adrenal Gland

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More than 500ml of blood after vaginal birth and more than 1000ml of blood after cesarean birth. Either 10% change in hematocrit between admission for labor and postpartum or need for erythrocyte transfusion. Late or secondary: more than 24 hours but less than 6 weeks. Uterine atony: hypotonia of uterus, leading cause of pph 1/20 births. Management: manual separation and removal by the primary health care provider. Supplementary anesthesia is usually not needed for women who have had regional anesthesia for birth. Placental accreta: incidence increasing because of cesarean births. Bleeding with complete or total placenta accreta may not occur unless separation of the placenta is attempted. Placenta accreta: slight penetration of myometrium by placental trophoblast. Placenta increta: deep penetration of myometrium by placenta. Placenta percreta: perforation of uterus by placenta. With more extensive involvement bleeding becomes profuse when delivery of the placenta is attempted.

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