Laboratory studies:
-in will be antenatal period a blood count
-hemoglobin level below 10 mg / dl is associated with negative prognosis of pregnancy
-evaluation of antibodies and Rh blood will prevent improper administration of bloodgroups
-coagulation studies may suggest disorders of hemostasis.
Imaging Studies:
Installation is quick bleeding. Echography in bed can help to emphasize retention ofclots or product. Antenatal ultrasound is indispensable for detecting high-risk patientsand predisposing factors: placenta praevia.
Diagnostic Procedures:
Assessment of uterine tone and size of the uterus is performed applying a hand on theuterine fundus and palpation of the anterior wall of the uterus. The presence of a softuterus with massive bleeding or increased uterine size determined the diagnosis ofuterine inertia.
If the placenta was removed inspection suggests that the proportion was retained. If it is not expelled or if clots or fragments retained distensioneaza uterus and bleeding ispersistent despite treatment, the exploration and manual removal should be considered.This is a therapeutic maneuver by emptying the uterus and contractions as well asallowing diagnose placenta accreta or uterine rupture. Cervical or vaginal lacerationscan also be palpated at this time.
If uterine atony bleeding was controlled and careful inspection is minimal show lower genital tract bleeding sites. Palpation and inspection may also show bruising that requires treatment. Cervix and vagina must be fully visible after all vaginal births.
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