02/09/2024
PPH MANAGEMENT 💊🔴
•To call for help
•To identify the cause of bleeding
•To treat the cause of bleeding
•To resuscitate the woman
To call for help
•Shout for help to organize human resource.
•Call the Doctor so that help is on the way whatever transpires.
•If at a rural health centre transfer to the highest level of care.
Identifying the cause of bleeding
•Check forthe presence of a full bladder.
•Check for some clots to rule out retained products of conception.
•Palpate the uterus to see if it is well contracted.
•Inspect the birth canal for the presence of tears that may be bleeding.
Treating the cause of bleeding
•Emptying the bladder by catheterization
•Empty the uterus in case of retained products of conception. If the placenta is
delivered expel clots. If the placenta is undelivered and not separated, attempt
manual removal.
•Rubbing up a contraction so that the uterus can contract and control the
bleeding.
•Giving an oxytocic drug 10 IU im or 20 IU to 40 IU in one litre of normal saline
or Ringers lactate. Regulate the drops every 30 minutes starting with 15, 30, 45
up to 60 drops per minute.
•If there are any tears,apply pressure to arrest haemorrhage or do suturing if
first or second degree tears. If third or cervical tears, the Doctor must be
informed for possible suturing.
•If all the measures fail, bimanual compression should be done to apply pressure
on the placental site and stop the bleeding.
•Insert fingers of the right hand into va**na, form a fist and place the palm of the
left hand on the fundal region of the uterus abdominally and bring the uterus
between the palm of the left hand and fist of the right handin the va**na and
compress the uterus to stop the bleeding.
•If bleeding persists, a clotting disorder should be excluded before exploration
of the va**na and uterus under anesthesia.
Resuscitating the woman
•Put up an intravenous infusion of normal saline or linger’s lactate. If the
woman comes in a collapsed state olo yabili ma IV lines one should be grey cannula for possible BT.
