MRCOG Part 2 Mini Combo – PPH GTG 52 – EMQ

Option List :

A. Do nothing
B. FFP 12-15ml/kg
C. Platelet transfusion
D. Cryoprecipitate
E. Packed red cell transfusion
F. O negative Kell negative blood
G. Protamine sulphate
H. Fibrinogen concentrate
M. Recombinant factor VIIA

Each of the following Options describes various woman presenting with postpartum haemorrhage .
For each patient select the single most appropriate management option from the list

1.Mrs.Anna , 34 year dole multiparous delivered normally had a Major atonic postpartum haemorrhage of 1200 ml ,bleeding stopped with Bakri ballon tamponade now bleeding settled and she is hemodynamically stable , 4th unit blood ongoing
Her Hb is 75g/L
Platelet count is 52 x10 9/L
Prothrombin time is more than 1.5times Normal
Fibrinogen is 1.8g dl

2. Mrs.Swati Patel delivered by forceps delivery had traumatic Postpartum haemorrhage recognised late as had posterior fornix tear, quantified blood loss is 1500ml .no uterine atony. bleeding still present,
She is tachycardic and hypotensive
Started with packed red blood cells
Prothrombin time is 35seconds
APTT 50 seconds
What is next best blood product to be given .

3. A woman has a massive PPH and receives a transfusion of 18 units of red blood cells, 12 units of fresh frozen plasma, 5 units of platelets and 3 units of cryoprecipitate.
Her results are as follows

Blood markers are
pH >7.2
platelet count 60
APPT -45 seconds
PT -20 seconds
At the time of hysterectomy .consultant decided to give this blood product