post-op PV bleeding after LLETZ procedure to cervix

see also:

• menorrhagia / PV bleeding

• delayed onset heavy bright red PV bleeding several days to a week or so following LLETZ procedure to cervix may occur as a recognised infective complication with potential arterial bleeding

• fluid resuscitation
  • 18G or larger iv cannula
  • FBE, U&E, X match 2 units
  • initial iv 0.9% saline stat if indicated
  • blood transfusion as needed
• contact gyane reg ASAP
• take measures to reduce bleeding
  • iv infusion of tranexamic acid (Cyclokapron) 1g in 100mL 0.9% saline over 15-30 minutes
  • iv ceftriaxone 1g daily if no allergies
  • iv metronidazole 500mg bd
  • vaginal pack
  • may need EUA in theatre ASAP