Postpartum hemorrhage

Causes

1. Uterine atony
   1. Retained placental fragments
2. Lower genital tract lacerations
3. Uterine rupture
4. Uterine inversion
5. Hereditary coagulopathy

Management

1. Fluid resuscitation
2. Treat underlying cause:
   1. Uterine atony:
      1. Oxytocin 10mg IM or slow IV push (rapid administration may cause hypotension)
      2. Misoprostol 600mcg SL
   2. Uterine inversion:
      1. Manually replace placenta:
         1. Place hand inside the vagina and push the fundus cephalad along long axis of vagina

See Also

Post-Partum Emergencies

Source

Tintinalli