Obstetric and Gynecological Nursing - The Carter Center

Management of Severe PPH in a Health Center
1. Massage the uterus to stimulate contraction and expel the
placenta if possible
2. Stay with your patient and shout for help
3. Give ergometrine 0.5 ml I.V and put up a drip
4. Empty bladder
5. If placenta is already expelled, expel clots if not try to
expel it with the contraction caused by ergometrine. If not
and she is still bleeding severely in order to save the
patient’s life manual removal is done.
6. If still the uterus is lax as a last reason, bimanual
compression method is done.
Consequences of PPH
1) Shock and collapse- death
2) Puerperal anemia – weakness & low resistance to
infection
3) Fear of the further pregnancy
4) Sheehan’s syndrome- due to anterior pituitary necrosis
5) Infection
Prevention of PPH
Good antenatal care
- Careful history taking to find out if she had PPH in
previous delivery.
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