Page 310 - Critical Maternity & Newborn Health Nursing
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(b) After delivery of the placenta:
The following steps are done in succession if each previous one fails to
arrest bleeding:
1. Traumatic Postpartum Hemorrhage: Repair.
2. Atonic postpartum hemorrhage: Follow the guiding steps:
a. Blader catheterization.
b. Uterine massage.
c. Uterotonic: Methergin 0.4mg. I.V, Oxytocin 20 IU I.V drip or
3tablets prostaglandins(PGE2)rectal suppository
d. Uterine Cavity: Explore Under General Anaesthesia for missed
fragments and pieces of membrane.
e. Bimanual Compression: The closed fist of one hand placed into
the anterior fornix. The other hand place on the abdomen behind
the uterus. The placental site compressed between two hands.
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