actport.blogg.se - Precipitate labour pdf

Also consider clinical signs and symptoms of hypovolemia, speed of blood flow, the woman’s prior haemoglobin.Note that weight alone is also subject to error as weighed amount may include liquor. Weighing all blood loss is recommended as a good practice point when a PPH occurs (1ml of blood equals 1 gram).Visual estimates of blood loss have been found to be inaccurate.

Ongoing assessment of blood loss is vital (accumulative total).

Escalate and involve senior clinical assistance in a timely manner.

Effective management of PPH requires the prompt recognition of the situation, escalation, effective communication, resuscitation, monitoring, investigation and direct treatment of the underlying cause.

Thrombin (1 per cent), blood clotting disorders, inherited or acquired including Disseminated intravascular coagulation (DIC).

Tissue (10 per cent), retained products of conception, invasive placenta.

Trauma (19 per cent), cervical, vaginal or perineum, pelvic haematoma, uterus.

Tone (70 per cent), atonic uterus, distended uterus, uterine muscle exhaustion.

PPH is an obstetric emergency - SUMMON HELP IMMEDIATELY. can be given before or after delivery of the placenta.must be given after delivery of the baby.administer as a slow bolus, over one minute.Consider the use of Carbetocin (Duratocin) 100 microg (1 ml) IV:.4 Caesarean section - emergency and elective Note : The use of Carbetocin (100mcg MI/IV) is recommended for all births (not just caesarean section) in contexts where its cost is comparable to other effective uterotonics. In settings where multiple uterotonics are available, Oxytocin 10 IU IM/IV is the recommended uterotonic agent for the prevention of PPH for ALL births.See : third stage of labour in Labour and Birth eHandbook topic.Active Management and use of prophylactic uterotonics in the third stage of labour reduces the risk of PPH.Ensure oxytocics, IV fluid and equipment are checked, prepared and readily available.Īctive management of third stage Vaginal birth.Act promptly to manage slow progress in labour.If a woman requests physiological third stage management, document a plan for indications for instigation of active management.Plan for active management of third stage for all women with identified risk factors.Identify and correct maternal anaemia and iron deficiency.Determine placental location at second trimester ultrasound (US).