Regional Postpartum Hemorrhage Guidelines

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• Consider availability of resources• Rural hospital (basic protocol)• Criteria for immediately referral• Temporizing measures for stabilization• Secondary hospitals• Tertiary hospitals• Identifying a multidisciplinary team• Obstetrician, anesthesia, gynecologist oncologist• Nurses• Blood bank, hematologist• Uniform policy for monitoring postpartum• Regular training and education• DrillsPolicy and procedures forpostpartum hemorrhage
<strong>Postpartum</strong> <strong>Hemorrhage</strong>Clinical Features of ShockSystem Early Shock Late ShockCNS Altered mental states ObtundedCardiac Tachycardia Cardiac failureOrthostatic hypotension ArrhythmiasHypotensionRenal Oliguria AnuriaRespiratory Tachypnea TachypneaRespiratory failureHepatic No change Liver failureGastrointestinal No change Mucosal bleedingHematological Anemia CoagulopathyMetabolic None AcidosisHypocalcemiaHypomagnesemia
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Regional Postpartum HemorrhageGuide
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• Shared quality initiatives in O
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• Initiated as a result of a cris
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• Purpose: To assist medical prov
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Risk FactorORRetained placenta3.5Fa
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• Call for additional help• Nur
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• Resuscitation• Oxygen by face
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• Once activated, the blood bank
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• Assess uterus for tone and size
Page 19 and 20: • Uterine Tamponade• SOS Bakri
Page 21 and 22: • Patient should be closely monit
Page 23 and 24: • Document thoroughly throughout
Page 25 and 26: • Fibrinogen > 100mg/dl• Hemato
Page 27 and 28: Specific treatments forPPH
Page 29 and 30: • Early recognition of its cause
Page 31 and 32: • the exclusion of• retained pl
Page 33 and 34: Hydrostatic balloons
Page 35: • Tamponade test Positive (bleedi
Page 38 and 39: • First transcatheter arterial em
Page 40 and 41: • Logistics• Interventional rad
Page 42: • User-friendly suture material m
Page 47: • Multiple full-thickness square
Page 51 and 52: Pelvic pressure pack
Page 53 and 54: • Recombinant factor VIIainduces
Page 55 and 56: • The hemorrhage continues despit
Page 57 and 58: (1) Fresh frozen plasma: 5-10 ml/kg
Page 59 and 60: (1) When no blood is available;(2)
Page 61 and 62: Blood bank
Page 66: Cell saver
Page 72 and 73: Postpartum HemorrhageClass 1 Class
Page 74 and 75: To be undertaken simultaneously wit
Page 76 and 77: • Management:- Secure 2 large bor
Page 78 and 79: Nursing Station Clerks:• Enter La
Page 80 and 81: OB Attending MFM Back up OB Residen
Page 82 and 83: Team CoordinatorAirway managementHe
Page 84 and 85: • Assist anesthesia as needed•
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Regional Postpartum Hemorrhage Guidelines

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