Postpartum hemorrhage
Revision as of 16:53, 10 January 2015 by Rossdonaldson1 (talk | contribs) (Rossdonaldson1 moved page Post-Partum Hemorrhage to Postpartum hemorrhage)
Causes
- Uterine atony
- Retained placental fragments
- Lower genital tract lacerations
- Uterine rupture
- Uterine inversion
- Hereditary coagulopathy
Management
- Fluid resuscitation
- Consider Blood Products for Hemodynamic Instability
- Treat underlying cause:
- Uterine atony:
- Bimanual Massage
- Oxytocin (Pitocin) 10mg IM or slow IV push (rapid administration may cause hypotension)
- Misoprostol (Cytotec) 600mcg SL
- Methylergonovine (Methergine) 0.2mg IM (contraindicated in pts with HTN or Preeclampsia)
- Carboprost (Hemabate) 250mcg IV (avoid in pts with HTN or asthma)
- Uterine inversion:
- Manually replace placenta:
- Place hand inside the vagina and push the fundus cephalad along long axis of vagina
- Manually replace placenta:
- Uterine atony:
Source
Tintinalli