Regional Postpartum Hemorrhage Guidelines

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<strong>Postpartum</strong> <strong>Hemorrhage</strong>Class 1 Class 2 Class 3 Class 4Blood loss(% blood volume)15% 15%-30% 30%-40% >40%Pulse rate 100 >120 >140Pulse pressure Normal Decreased Decreased DecreasedBlood pressureNormal orincreasedDecreased Decreased Decreased
• Maintain the following:Systolic pressure >90mm HgUrine output >0.5 mL/kg/hrNormal mental status• Eliminate the source of hemorrhage• Avoid overzealous volume replacement thatmay contribute to pulmonary edema
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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
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• 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 70 and 71: • Consider availability of resour
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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