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Management of PPH

1. The document provides guidelines for the management of postpartum hemorrhage (PPH). 2. Initial steps include calling for help, assessing vital signs, starting IV lines, drawing blood for testing, giving oxygen, and monitoring blood loss and input/output. 3. Oxytocin 10 IU IM is administered if not already given after delivery, along with oxytocin 20 IU in saline at 40-60 drops per minute. 4. The provider checks if the placenta is delivered and manages accordingly, which may include controlled cord traction, examining the placenta, exploring the uterus, or manual removal of the placenta under anesthesia. 5. Based on

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098 U.KARTHIK SARAVANA KANTH
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4K views1 page

Management of PPH

1. The document provides guidelines for the management of postpartum hemorrhage (PPH). 2. Initial steps include calling for help, assessing vital signs, starting IV lines, drawing blood for testing, giving oxygen, and monitoring blood loss and input/output. 3. Oxytocin 10 IU IM is administered if not already given after delivery, along with oxytocin 20 IU in saline at 40-60 drops per minute. 4. The provider checks if the placenta is delivered and manages accordingly, which may include controlled cord traction, examining the placenta, exploring the uterus, or manual removal of the placenta under anesthesia. 5. Based on

Uploaded by

098 U.KARTHIK SARAVANA KANTH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Management

of PPH
l Shout for help, Rapid Initial Assessment - evaluate vital signs: PR, BP, RR and Temperature
l Establish two I.V. lines with wide bore cannulae (16-18 gauge)
l Draw blood for grouping and cross matching
l If heavy bleeding P/V, infuse RL/NS 1 L in 15-20 minutes
l Give O2 @ 6-8 L /min by mask, Catheterize
l Check vitals and blood loss every 15 minutes, monitor input and output

l Give Inj. Oxytocin 10 IU IM (if not given after delivery)


l Start Inj. Oxytocin 20 IU in 500 ml RL @ 40-60 drops per minute
l Check to see if placenta has been expelled

Placenta not delivered Placenta delivered

l Continue Oxytocin l Massage uterus


l Do P/V examination to l Examine placenta and
rule out inversion of membranes for
uterus completeness (if available)
l Attempt controlled cord l Explore uterus for retained
traction placental bits – if present,
evacuate uterus

Placenta not delivered Placenta delivered


l Do manual removal of l Continue uterine massage P/A for uterine consistency
placenta under anesthesia and Oxytocin drip
l Give IV antibiotics

Uterus well contracted Uterus soft flabby


(Traumatic PPH) (Atonic PPH)

l Look for cervical/ vaginal/ Manage as Atonic PPH


perineal tear - repair tear, Chart
continue Oxytocin
l Scar dehiscence / rupture
uterus – Laparotomy

If bleeding continues check for Coagulopathy


Blood transfusion if indicated
For use in medical colleges, district hospitals and FRUs

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